Digital single-operator cholangioscopy for endoscopic retrograde appendicitis therapy (ERAT)

Abstract

Objective: To investigate the diagnostic and therapeutic value of the SpyGlass DS (single-operator cholangioscopy system) for endoscopic management of acute appendicitis. Methods: Fourteen patients with acute uncomplicated simple or supportive appendicitis were evaluated between November 2018 and September 2020. The diagnosis of acute appendicitis was confirmed by colonoscopy direct vision imaging and Spyglass imaging. The successful rate of the Spy-Glass DS assisted endoscopic retrograde appendicitis therapy, the procedure time, post-operative length of hospital stay, complications, and recurrence rate were recorded Results: The procedure technical success rate was 100% with high quality imaging of the appendiceal cavity of all 14 patients using SpyGlass DS. The average procedure time was 37.8 ± 22 min. Abdominal pain was relieved immediately after the procedure in all patients. The average post-operative hospital was 1.9 ± 0.7 days. No recurrence occurred during 2 to 24 months of follow-up. Conclusion: Spyglass-assisted endoscopic retrograde appendicitis therapy provides a feasible, safe, effective alternative approach to diagnose and management of acute uncomplicated appendicitis without the need for X-ray or ultrasonic guidance.