PMID- 32118109
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20200928
IS  - 2364-3722 (Print)
IS  - 2196-9736 (Electronic)
IS  - 2196-9736 (Linking)
VI  - 8
IP  - 3
DP  - 2020 Mar
TI  - Bimodal ERCP, a new way of seeing things.
PG  - E368-E376
LID - 10.1055/a-1070-8749 [doi]
AB  - Background and study aims  Conventional endoscopic retrograde 
      cholangiopancreatography (ERCP) is hampered by two-dimensional visualization, 
      post-procedural adverse events (AEs), and exposure to ionizing radiation. Bimodal 
      ERCP might mitigate these challenges, but no reports of its use are available to 
      date. The aim of this study was to explore the feasibility of bimodal ERCP, while 
      investigating its potential clinical yield. Patients and methods  This was a 
      retrospective observational study of patients that underwent bimodal ERCP in a 
      single tertiary academic referral center. Thirteen patients undergoing 
      conventional ERCP had a previously T2-weighted isotropic 3 D TSE MRCP sequence 
      aligned and fused with the two-dimensional image generated from the fluoroscopy 
      c-arm unit in real time. Results  Over a 2-month period, 13 patients with a mean 
      age of 54 underwent bimodal ERCP for bile duct stricture (61.5 %), complex 
      cholelithiasis (7.7 %) and ductal leakage (30.1 %). Bimodal ERCP was feasible in 
      all 13 cases, and image quality was assessed as "good" in 11 patients (84.6 %). 
      Bimodal ERCP aided in visualizing the lesion of interest (76.9 %), assisted in 
      understanding the 3 D anatomy of the biliopancreatic ductal system (61.5 %), and 
      aided in finding a favorable position for the c-arm (38.4 %) for subsequent 
      therapeutic intervention. Conclusions  This first report on bimodal ERCP proves 
      its feasibility and suggests that it may assist in increasing both the diagnostic 
      and therapeutic yield of ERCP, while at the same time decreasing AEs during and 
      after ERCP. Its main application might lie in treatment of complex intrahepatic 
      disease.
FAU - Reuterwall, Marcus
AU  - Reuterwall M
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
AD  - Ersta Hospital - Surgery, Stockholm, Sweden.
FAU - Waldthaler, Alexander
AU  - Waldthaler A
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
AD  - Karolinska University Hospital - Upper Abdominal Diseases, Stockholm, Sweden.
FAU - Lubbe, Jeanne
AU  - Lubbe J
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
AD  - University Stellenbosch - Division of Surgery, Stellenbosch, Western Cape, South 
      Africa.
FAU - Kadesjo, Nils
AU  - Kadesjo N
AD  - Karolinska University Hospital - Medical Radiation and Physics and Nuclear 
      Medicine, Stockholm, Sweden.
FAU - Pozzi Mucelli, Raffaella
AU  - Pozzi Mucelli R
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
AD  - Karolinska University Hospital - Abdominal Radiology, Stockholm, Sweden.
FAU - Del Chiaro, Marco
AU  - Del Chiaro M
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
FAU - Lohr, Matthias
AU  - Lohr M
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
FAU - Arnelo, Urban
AU  - Arnelo U
AD  - Karolinska Institute, CLINTEC, Stockholm, Sweden.
AD  - Karolinska University Hospital - Upper Abdominal Diseases, Stockholm, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20200221
PL  - Germany
TA  - Endosc Int Open
JT  - Endoscopy international open
JID - 101639919
PMC - PMC7035029
COIS- Competing interests The authors declare that they have no conflict of interest.
EDAT- 2020/03/03 06:00
MHDA- 2020/03/03 06:01
PMCR- 2020/03/01
CRDT- 2020/03/03 06:00
PHST- 2019/06/26 00:00 [received]
PHST- 2019/11/04 00:00 [accepted]
PHST- 2020/03/03 06:00 [entrez]
PHST- 2020/03/03 06:00 [pubmed]
PHST- 2020/03/03 06:01 [medline]
PHST- 2020/03/01 00:00 [pmc-release]
AID - 10.1055/a-1070-8749 [doi]
PST - ppublish
SO  - Endosc Int Open. 2020 Mar;8(3):E368-E376. doi: 10.1055/a-1070-8749. Epub 2020 Feb 
      21.