Abstract:
BACKGROUND:The "mother-baby" endoscope system currently used for peroral cholangioscopy (POC) has several limitations. Endoscopic direct cholangioscopy when using an ultra-slim upper endoscope with a guidewire to maintain access has been reported, but appropriate accessories are required to increase the success rate. Herein, we describe a novel method, overtube-balloon-assisted endoscopy, for direct POC. OBJECTIVE:To evaluate the feasibility and usefulness of direct POC when using an ultra-slim upper endoscope with an overtube balloon to maintain access. SETTING:A single center. DESIGN:Case series. PATIENTS:Twelve patients with biliary disease. INTERVENTIONS:Direct POC by using an ultra-slim upper endoscope and diagnostic and/or therapeutic procedures. MAIN OUTCOME MEASUREMENTS:Success rate of this technique, diagnostic or therapeutic feasibility, and complications. RESULTS:Overtube-balloon-assisted direct POC was performed successfully in 10 of 12 patients (83.3%). The procedure revealed 4 common bile duct (CBD) stones, 4 benign biliary strictures, 1 polypoid tumor, and 1 cholangiocarcinoma. Five patients underwent forceps biopsy under direct visualization of the intraductal lesion. Laser lithotripsy was successfully performed in 1 patient. No procedure-related complication occurred. LIMITATIONS:A small number of patients and no comparison with conventional cholangioscopy. CONCLUSIONS:The overtube balloon appears to be a useful accessory in direct POC when using an ultra-slim upper endoscope. However, further development of a slim overtube or other accessories is necessary to improve the success rate of direct POC.
journal_name
Gastrointest Endoscjournal_title
Gastrointestinal endoscopyauthors
Choi HJ,Moon JH,Ko BM,Hong SJ,Koo HC,Cheon YK,Cho YD,Lee JS,Lee MS,Shim CSdoi
10.1016/j.gie.2008.08.043subject
Has Abstractpub_date
2009-04-01 00:00:00pages
935-40issue
4eissn
0016-5107issn
1097-6779pii
S0016-5107(08)02501-7journal_volume
69pub_type
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