Visibility of the biliary orifice after precut papillotomy: Comparison between white light imaging and texture and color enhancement imaging

IF 3.2 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Hepato‐Biliary‐Pancreatic Sciences Pub Date : 2024-06-02 DOI:10.1002/jhbp.12005
Haruka Toyonaga, Toshifumi Kin, Hajime Yamazaki, Ryo Ando, Kosuke Iwano, Risa Nakamura, Tatsuya Ishii, Tsuyoshi Hayashi, Kuniyuki Takahashi, Akio Katanuma
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Abstract

Background

Precut papillotomy is performed in cases of difficult biliary cannulation, but identification of the biliary orifice is difficult. Texture and color enhancement imaging (TXI) can enhance the structure, color, and brightness. This study compared TXI and white light imaging (WLI) in visibility of biliary orifices.

Methods

We retrospectively examined 20 patients who underwent bile duct cannulation using both WLI and TXI after precut papillotomy at our center between 2021 and 2022. On WLI and TXI images displayed in random order, bile duct orifice on precut-incision surface of each image was independently evaluated by eight evaluators. Single-indication accuracy rate of biliary orifices, visibility score rated on a 4-grade scale, and color difference between the biliary orifice and the surrounding tissue were examined.

Results

The single-indication accuracy rate was higher in TXI compared to WLI (50.6% vs. 35.6%, odds ratio 2.26 [95% CI: 1.32–3.89], p = .003). The time to indicate the biliary orifice was comparable between TXI and WLI (median, 9.7 s [range, 2.6–43] vs. 10.9 s [1.5–64], p = .086). Furthermore, the visibility score was higher in TXI than in WLI (median, 3 [interquartile range, 2–3] vs. 2 [2, 3], p < .001), and the color difference between the biliary orifice and surrounding tissue in TXI was more pronounced than in WLI (median, 22.9 [range, 9.39–55.2] vs. 18.0 [6.48–43.0]; p < .001).

Conclusions

TXI enhanced the color difference and visibility of the biliary orifice after precut and improved single-indication accuracy rate, suggesting that it could be useful for biliary cannulation after precut papillotomy.

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预切乳头切开术后胆道口的可见度:白光成像与纹理和色彩增强成像的比较。
背景:预切乳头切开术适用于胆道插管困难的病例,但很难识别胆道口。纹理和颜色增强成像(TXI)可增强结构、颜色和亮度。本研究比较了纹理和颜色增强成像(TXI)与白光成像(WLI)在胆道口可见性方面的差异:我们回顾性检查了 2021 年至 2022 年期间在本中心接受预切乳头切开术后使用 WLI 和 TXI 进行胆管插管的 20 例患者。在随机显示的 WLI 和 TXI 图像上,每张图像的切前切口表面的胆管口由 8 位评估者独立评估。对胆管口的单一指示准确率、4 级可视度评分以及胆管口与周围组织的色差进行了检查:结果:与 WLI 相比,TXI 的单一指示准确率更高(50.6% 对 35.6%,几率比 2.26 [95% CI:1.32-3.89],P = .003)。TXI 和 WLI 显示胆道开口的时间相当(中位数为 9.7 秒 [2.6-43] vs. 10.9 秒 [1.5-64],p = .086)。此外,TXI 的可见度得分高于 WLI(中位数,3 [四分位间范围,2-3] vs. 2 [2,3],p 结论:TXI 增强了色差和可见度:TXI 增强了预切开术后胆道口的色差和可见度,并提高了单一指示的准确率,这表明它可用于预切开乳头切开术后的胆道插管。
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来源期刊
Journal of Hepato‐Biliary‐Pancreatic Sciences
Journal of Hepato‐Biliary‐Pancreatic Sciences GASTROENTEROLOGY & HEPATOLOGY-SURGERY
自引率
10.00%
发文量
178
审稿时长
6-12 weeks
期刊介绍: The Journal of Hepato-Biliary-Pancreatic Sciences (JHBPS) is the leading peer-reviewed journal in the field of hepato-biliary-pancreatic sciences. JHBPS publishes articles dealing with clinical research as well as translational research on all aspects of this field. Coverage includes Original Article, Review Article, Images of Interest, Rapid Communication and an announcement section. Letters to the Editor and comments on the journal’s policies or content are also included. JHBPS welcomes submissions from surgeons, physicians, endoscopists, radiologists, oncologists, and pathologists.
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