摘要
To the Editor:Trauma, inflammation, iatrogenic procedures such as liverbiopsy and percutaneous transhepatic biliary drainage (PTBD), vascularanomalies, coagulopathy status, and malignancy can causehemobilia [1]. Malignant causes of hemobilia include cholangiocarcinoma,pancreatic cancer, gallbladder tumor, and liver metastasis,but rarely hepatocellular carcinoma (HCC). Here, we describeachieving endoscopic hemostasis for hemobilia caused by HCC,which was visualized using the single-operator, SPY-DS cholangioscope(Boston Scientific, Tokyo, Japan) under endoscopic retrogradecholangiopancreatography (ERCP) guidance. This scope is a dramaticimprovement over the SpyGlass system in that it is easier to insert into the biliary tract due to a tapered tip, a 120° digitalfield-of-view provides favorable visualization, and new injection and suction functions have been added via a two-port adaptor.
To the Editor:Trauma, inflammation, iatrogenic procedures such as liverbiopsy and percutaneous transhepatic biliary drainage (PTBD), vascularanomalies, coagulopathy status, and malignancy can causehemobilia [1]. Malignant causes of hemobilia include cholangiocarcinoma,pancreatic cancer, gallbladder tumor, and liver metastasis,but rarely hepatocellular carcinoma (HCC). Here, we describeachieving endoscopic hemostasis for hemobilia caused by HCC,which was visualized using the single-operator, SPY-DS cholangioscope(Boston Scientific, Tokyo, Japan) under endoscopic retrogradecholangiopancreatography (ERCP) guidance. This scope is a dramaticimprovement over the SpyGlass system in that it is easier to insert into the biliary tract due to a tapered tip, a 120° digitalfield-of-view provides favorable visualization, and new injection and suction functions have been added via a two-port adaptor.