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SpyGlass™ DS II Direct Visualization System in physician's hands.

Managing indeterminate strictures with SpyGlass™ DS

Common bile duct strictures and pancreatic duct strictures

The SpyGlass DS II enables imaging of the biliary and pancreatic ducts, as well as potential indeterminate pancreatic or biliary strictures, during endoscopic retrograde cholangiopancreatography (ERCP). Performing biopsies under direct visualization using the SpyGlass DS System and SpyBite™ Biopsy Forceps may enable more definitive diagnosis of malignancies through increased sensitivity1 compared to brush cytology.2

Biliary stricture case studies*

On Target: How to Treat Biliary Strictures

Dr. Jennifer Phan 

Assistant Professor of Clinical Medicine

Keck School of Medicine

University of Southern California (USC)

Listen to Dr. Phan share why she chooses to start with Cholangioscopy over cytology brushing to efficiently diagnose indeterminate strictures.

Listen to On Target: How to Treat Strictures podcast

Cholangioscopy Guided Biopsy of a Biliary Stricture

Dr. Mankanwal Sachdev

Gastroenterology

Banner Desert Medical Center, Arizona

A patient underwent ERCP with cholangioscopy for biliary stricture evaluation. A subtle abnormality was found and multiple tissue samples were collected with Spybite forceps.

Watch Cholangioscopy Guided Biopsy video

Diagnosing Cholangiocarcinoma: SpyGlass DS Direct Visualization System with SpyBite Max Biospy Forceps

Dr. Margaret Geraldine Keane

Assistant Professor of Medicine

Johns Hopkins Medicine

Read this case study to see how Dr. Keane used cholangioscopy with pathology to diagnose cholangiocarcinoma at an early stage.

Download the Diagnosing Cholangiocarcinoma case study

Assessing a Bile Duct Stricture Using the SpyGlassTM DS Direct Visualization System

Dr. Srinadh Komanduri

Interventional Gastroenterologist, Northwestern Medical Group

Associate Chief of Gastroenterology and Hepatology 

Director of Endoscopy, Northwestern Feinberg School of Medicine

This video shows how the cholangioscope’s detailed imaging and direct access helped Dr. Komanduri to efficiently visualize a stricture and capture a biopsy, significantly changing the treatment pathway and avoiding a second procedure.

Watch the Assessing a Bile Duct Stricture video

Multi-Disciplinary Approach to Managing a Common Biliary Duct Stricture

Dr. Abdul Aziz Aadam

Gastroenterologist 

Northwestern Medical Group 

Chicago, IL

See this case review where a malignant stricture caused significant bile duct dilation. After an unsuccessful ERCP, cholangioscopy allowed for stent placement and biopsy.

Watch the Multi-Disciplinary Approach video

ERCP Direct Visualization Leads to Rare Diagnosis Using the SpyGlass DS II Direct Visualization System

Dr. Pushpak Taunk

Associate Professor of Medicine Division of Digestive Diseases and Nutrition 

University of South Florida Morsani College of Medicine 

Tampa General Hospital

Dr. Taunk shares the case of a 64-year-old patient with IgG4 sclerosing cholangitis, a rare autoimmune disorder. Through direct visualization, Dr. Taunk identified the irregular biliary mucosa and then used SpyBite™ Max Biopsy Forceps to obtain biopsies of the biliary stricture and irregularities — which led to the rare diagnosis.

Download the ERCP Direct Visualization case study

Want more resources for your next stricture case?

Access our EduCare platform for educational resources for you and your staff to confidently tackle indeterminate strictures.

Go to EduCare

1. 86% sensitivity of DSOC demonstrated in Shah RJ, Raijman I, Brauer B, Gumustop B, Pleskow DK. Performance of a fully disposable, digital, single-operator cholangiopancreatoscope. Endoscopy. 2017 Jul;49(7):651-658. doi: 10.1055/s-0043-106295. 

2. Results from a comparative study where the pooled sensitivity and specificity of brushings for the diagnosis of malignant biliary strictures was 45% (95% confidence interval [CI], 40%–50%) and 99% (95% CI, 98%–100%), respectively** demonstrated in Navaneethan U, Zhu X, Lourdusamy D, Lourdusamy V, Vardarajulu S. Sa1378 Comparative effectiveness of various ERCP based modalities for detection of malignant biliary strictures. Gastrointest Endosc. 2017;85(Suppl 5): AB216–AB217.

*Results from case studies are not necessarily predictive of results in other cases. Results in other cases may vary.

**Results from different clinical investigations are not directly comparable. Information provided for educational purposes only.

Indications, Safety, and Warnings for SpyScope™ DS II

Indications, Safety, and Warnings for SpyBite™ Single-Use Biopsy Forceps

Indications, Safety, and Warnings for SpyBite Max™ Single-Use Biopsy Forceps

CAUTION: The law restricts these devices to sale by or on the order of a physician. Indications, contraindications, warnings, and instructions for use can be found in the product labelling supplied with each device or at www.IFU-BSCI.com. Products shown for INFORMATION purposes only and may not be approved or for sale in certain countries. This material not intended for use in France.