spracticeХирургическая практикаSurgical practice (Russia)2223-2427АНО "Консорциум "Медицинская техника"10.5922/2223-2427-2025-10-1-7spractice-552Research ArticleКЛИНИЧЕСКИЕ НАБЛЮДЕНИЯВозможности пероральной холангиоскопии в диагностике первичного склерозирующего холангитаRole of peroral cholangioscopy in the diagnosis of primary sclerosing cholangitishttps://orcid.org/0000-0002-7039-8857КурдановаМ. Ю.KurdanovaM. Y.

Мадина Юсуповна Курданова - врач-эндоскопист, эндоскопическое отделение

115522, Москва, Каширское шоссе, 23

Madina Y. Kurdanova - Endoscopist, Department of Endoscopy

Kashirskoye highway, 23, Moscow, 115522

Kurdanova.madina97@yandex.ruhttps://orcid.org/0000-0002-5247-3219ИмаралиевО. ТImaralievO. T.

Оятиддин Турсунович Имаралиев - врач-эндоскопист, эндоскопическое отделение

115522, Москва, Каширское шоссе, 23

Oyatiddin T. Imaraliev - Endoscopist, Department of Endoscopy

Kashirskoye highway, 23, Moscow, 115522

o.imaraliev@ronc.ruhttps://orcid.org/0000-0002-7434-2674ТимофеевМ. Е.TimofeevM. E.

Михаил Евгеньевич Тимофеев - доктор медицинских наук, врач-эндоскопист, эндоскопическое отделение

115522, Москва, Каширское шоссе, 23

Mikhail E. Timofeev - Associate professor, Endoscopist, Department of Endoscopy

Kashirskoye highway, 23, Moscow, 115522

metimofeev@mail.ruhttps://orcid.org/0000-0002-7025-970XКарасевИ. А.KarasevI. A.

Иван Александрович Карасев – кандидат медицинских наук, врач-эндоскопист, заведующий эндоскопическим отделением

115522, Москва, Каширское шоссе, 23

Ivan A. Karasev - Associate professor, Endoscopist, Department of Endoscopy

Kashirskoye highway, 23, Moscow, 115522

ronc-karasev@yandex.ruhttps://orcid.org/0000-0002-5614-8405СалимоваА. А.SalimovaA. A.

Алина Абдуловна Салимова - врач-эндоскопист, эндоскопическое отделение

115522, Москва, Каширское шоссе, 23

Alina A.Salimova - Endoscopist, Department of Endoscopy

Kashirskoye highway, 23, Moscow, 115522

alina.salimova@gmail.comНациональный медицинский исследовательский центр онкологии им. Н.Н. БлохинаРоссияN.N. Blokhin National Medical Research Center of OncologyRussian Federation202517052025018695Copyright © Курданова М.Ю., Имаралиев О.Т., Тимофеев М.Е., Карасев И.А., Салимова А.А., 20252025Курданова М.Ю., Имаралиев О.Т., Тимофеев М.Е., Карасев И.А., Салимова А.А.Kurdanova M.Y., Imaraliev O.T., Timofeev M.E., Karasev I.A., Salimova A.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.spractice.ru/jour/article/view/552Цель

Цель. Продемонстрировать лечебно-диагностические возможности пероральной холангиоскопии в диагностике и симптоматическом лечении первичного склерозирующего холангита.

Материалы и методы

Материалы и методы. В связи с наличием недифференцированной стриктуры по данным инструментальных методов обследования, в представленном клиническом случае была выполнена пероральная холангиоскопия. В качестве дочернего аппарата использовали систему эндоскопической визуализации желчевыводящих путей SpyGlass DS II (Boston Scientific). Внутрипротоковую биопсию выполняли с помощью щипцов SpyBite Max. Учитывая визуальную картину внутрипеченочного холангиолитиаза, крупных конкрементов, с куративной целью была выполнена контактная лазерная литотрипсия с использованием тулиевого лазера.

Результаты

Результаты. Данные визуального осмотра билиарного дерева, внутрипротоковой биопсии подтвердили диагноз первичного склерозирующего холангита. Использование контактной лазерной литотрипсии позволило осуществить адекватное дренирование.

Заключение

Заключение. Методика пероральнорй холангиоскопии позволяет выполнять прицельную биопсию измененных тканей, позволяет обеспечить адекватную декомпрессию; является эффективной в дифференциальной диагностике различных поражений желчевыводящих протоков.

Aim

Aim. To demonstrate the therapeutic and diagnostic capabilities of peroral cholangioscopy in the diagnosis and symptomatic treatment of primary sclerosing cholangitis.

Materials and methods

Materials and methods. Due to the presence of undifferentiated stricture, according to instrumental examination methods, peroral cholangioscopy was performed in the presented case. The SpyGlass DS II (Boston Scientific) biliary tract endoscopic imaging system was used as a daughter device. Intraductal biopsy was performed using SpyBite Max forceps. Taking into account the visual picture of intrahepatic cholangiolithiasis, large stones, contact laser lithotripsy using a thulium laser was performed for curative purposes.

Results

Results. Visual examination of the biliary tree and intra-flow biopsy confirmed the diagnosis of primary sclerosing cholangitis. The use of contact laser lithotripsy made it possible to carry out adequate drainage.

Conclusion

Conclusion. The peroral cholangioscopy technique allows for targeted biopsy of altered tissues under double (endoscopic and X-ray) control, is effective and relatively safe in the differential diagnosis of various lesions of the bile ducts.

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The authors declare that there are no conflicts of interest present.