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How to Perform a Spy-Glass Cholangioscopy: Step-by-Step Guide.

SpyGlass cholangioscopy is a revolutionary technique that allows for direct visualization of the bile ducts, aiding in the diagnosis and treatment of various biliary disorders. This minimally invasive procedure offers high-resolution imaging and precise navigation, making it an invaluable tool for gastroenterologists and hepatobiliary surgeons. In this step-by-step guide, we will outline the essential steps involved in performing SpyGlass cholangioscopy.Best Hepatologist in Rohini Sector 7

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Step 1: Patient Preparation

Before beginning the procedure, ensure that the patient has been adequately prepared. This may include fasting for a certain period and discontinuation of blood-thinning medications to minimize the risk of bleeding. Additionally, patients may receive sedation or anesthesia to ensure comfort during the procedure.

Step 2: Endoscopic Access

The first step in performing SpyGlass cholangioscopy is to gain access to the biliary system using standard endoscopic techniques. This typically involves inserting an endoscope through the mouth and advancing it through the esophagus and stomach until reaching the duodenum.

Step 3: Cannulation of the Bile Duct

Once the endoscope is in the duodenum, the next step is to cannulate the bile duct using a catheter or guidewire. This allows access to the biliary tree, where the SpyGlass cholangioscope will be inserted.

Step 4: Insertion of the SpyGlass Cholangioscope

With the bile duct cannulated, the SpyGlass cholangiocyte is carefully inserted through the working channel of the endoscope and advanced into the bile duct. The cholangiocyte consists of a flexible, fiber-optic probe equipped with a camera at its tip, allowing for direct visualization of the bile ducts.

Step 5: Image Acquisition

Once the SpyGlass cholangiocyte is in position within the bile duct, images are acquired in real time, providing high-resolution visualization of the biliary anatomy. The SpyGlass system also allows for the administration of saline or contrast agents to enhance imaging and facilitate the identification of abnormalities such as strictures, stones, or tumors.

Step 6: Navigation and Inspection

Using the joystick-controlled steering mechanism of the SpyGlass cholangiocyte, the operator can navigate through the bile ducts and inspect the entire biliary tree systematically. Careful examination is performed to identify any lesions or abnormalities, which may require further intervention or biopsy.

Step 7: Therapeutic Interventions

In addition to diagnostic imaging, SpyGlass cholangioscopy enables a range of therapeutic interventions to be performed directly within the bile ducts. These may include stone extraction, balloon dilation of strictures, laser lithotripsy, or the placement of stents to relieve biliary obstruction.

Step 8: Post-procedure Care

After the SpyGlass cholangioscopy procedure is completed, the cholangioscope is carefully removed, and the bile duct cannula is withdrawn. Patients are typically monitored for a brief period in a recovery area to ensure there are no immediate complications. Post-procedure care instructions are provided, and patients may be advised to resume their normal activities gradually.

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SpyGlass cholangioscopy is a valuable diagnostic and therapeutic tool for the management of biliary disorders. By following this step-by-step guide, gastroenterologists and hepatobiliary surgeons can perform SpyGlass cholangioscopy safely and effectively, offering patients accurate diagnosis and tailored treatment options for a wide range of biliary conditions.Best Hepatologist in Rohini Sector 7

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