Geisinger Wyoming Valley helps pioneer system to alter diagnosis and treatment of patients with liver, gallbladder and bile duct conditions

WILKES BARRE — Almost half a million people annually in the U.S. undergo a procedure called an ERCP to diagnose problems in their liver, gallbladder and bile ducts. David Schaefer, MD, PhD, a gastroenterologist at Geisinger Wyoming Valley (GWV) is now using a new cholangioscopy technology to diagnose and treat conditions such as obstructions and stones within the biliary tract.

The device, known as the SpyGlass™ Direct Visualization System, includes a miniature 6,000 pixel fiber optic probe that provides physicians with a direct view of a patient’s bile ducts, overcoming some of the visual challenges of conventional ERCP procedures. Dr. Schaefer was specifically chosen by Boston Scientific to do this procedure at Geisinger Wyoming Valley. GWV is one of only approximately 30 institutions in the United States to have this technology.

As part of the traditional ERCP procedure, physicians use an endoscope – a long, flexible, lighted tube that is inserted through a patient’s mouth and directed through the stomach into the first part of the small intestine – in order to view the entrance to the biliary tract. At this point x-rays may be taken of the inside of the biliary tract. However, these x-rays are two-dimensional black and white images that often do not provide enough information to obtain a complete diagnosis.

Data shows that up to 30 percent of ERCPs performed using brush cytology or biopsy forceps for tissue diagnosis are inconclusive, potentially creating the need for additional testing or repeat procedures. Besides being inconvenient for patients having to return to the hospital, the procedure can take two or more hours and typically requires them not to eat or drink six to eight hours beforehand.

The SpyGlass System, developed by Boston Scientific Corporation, provides direct visual access into a patient’s biliary duct to improve diagnosis by helping to identify stones and strictures (obstructions). A fiber optic probe attaches to a camera head and is inserted through a single-use catheter that can be steered in four directions. This is designed to allow the user to access and inspect all four quadrants of the examination and treatment area. As a result, physicians are able to achieve an improved diagnosis for patients.

Click photo for Hi-Res Version

####