Together we shape the future of HPB

Raising the​ standard of​ care in diagnosis​

Diagnosing lesions remains challenging

SpyGlass clinical SpyBite

Any delay to diagnosis may directly affect patient outcomes. Yet, an accurate diagnosis can be challenging even after tissue-based diagnostic investigations have been attempted. About 15–20% of patients with indeterminate biliary structures who undergo surgery are found to have benign disease, with high postoperative mortality (10%) reported in many western referral centers.²

A delayed diagnosis of malignancy may result in a more invasive surgical procedure³ or patients may no longer be surgical candidates.⁴​

Accurate diagnosis is as challenging as it is important1,2,5,6

There are different diagnostic methods available for evaluating strictures, each comes with benefits and limitations.2,5 Based on the type and location of the suspected mass, careful selection of EUS and/or ERCP-based sampling techniques is required to optimize diagnostic accuracy.2


In a recent economic analysis, it is suggested that SpyGlass DS could perform better than ERCP cytology brushing for the diagnosis of bile duct strictures and reduced the overall expenditure of hospitals in Belgium.3


In the same study, it was suggested SpyGlass DS could help reduce number of repeat procedures, hence reducing the overall expenditure of hospitals.3


This study suggested that the use of intra-ductal cholangioscopy avoids 31% of procedures (diagnostic and surgical).3

Optimizing hospital resources – an urgent requirement​

Acquire Needle clinical setting

Strain on health systems has been exacerbated by the COVID-19 pandemic, resulting in patient backlogs and driving the need for improved operational efficiency.​

​This can be achieved by avoiding repeat procedures, reducing the length of those that are carried out, and delivering cost savings while simultaneously maintaining – or improving – the standard of care.​

Driving innovation in HPB diagnosis​

At Boston Scientific, we understand the challenges you may face in achieving a diagnosis for your patients. We have developed a suite of solutions to help support them:​

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1. Gerges C, Beyna T, Tang RSY, et al. Digital single-operator peroral cholangioscopy-guided biopsy sampling versus ERCP-guided brushing for indeterminate biliary strictures: a prospective, randomized, multicenter trial (with video). Gastrointest Endosc. 2020;91(5):1105–1113.​

2. Del Vecchio Blanco G, Mossa M, Troncone E, et al. Tips and tricks for the diagnosis and management of biliary stenosis-state of the art review. World J Gastrointest Endosc. 2021;13(10):473–490.​

​3. Deprez PH, Garces Duran R, Moreels T, et al. The economic impact of using single-operator cholangioscopy for the treatment of difficult bile duct stones and diagnosis of indeterminate bile duct strictures. Endoscopy. 2018;50(2):109–118.

4. Victor DW, Sherman S, Karakan T, et al. Current endoscopic approach to indeterminate biliary strictures. World J Gastroenterol. 2012;18(43):6197–205.​

5. Almadi MA, Itoi T, Moon JH, et al. Using single-operator cholangioscopy for endoscopic evaluation of indeterminate biliary strictures: results from a large multinational registry. Endoscopy. 2020;52(7):574–582.​

​6. Angsuwatcharakon P, Kulpatcharapong S, Moon JH, et al. Consensus guidelines on the role of cholangioscopy to diagnose indeterminate biliary stricture. HPB. 2022;24(1):17–29.​

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