Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Area of Science:

• Gastroenterology
• Endoscopy
• Biliary Tract Imaging

Background:

• Cholangioscopy is vital for diagnosing and treating biliary pathology.
• Ultrathin endoscopes enable direct peroral cholangioscopy (DPC), but present challenges.

Purpose of the Study:

• To assess the success rate of DPC using an ultrathin endoscope.
• To evaluate the efficacy of a balloon catheter in reaching the biliary confluence during DPC.

Main Methods:

• A prospective observational study involving 15 patients.
• Utilized an ultrathin endoscope (5.5 mm outer diameter) and an intraductal balloon catheter (1.9 mm diameter).
• Employed a free-hand technique for biliary tree access and a balloon catheter for reaching the biliary confluence.

Main Results:

• Biliary tree access was successful in 93.3% of cases (14/15).
• The biliary confluence was reached in 86.7% of cases (13/15).
• One complication (oxygen desaturation) occurred in a single patient.

Conclusions:

• Direct peroral cholangioscopy with an ultrathin endoscope is feasible using a free-hand technique.
• Intraductal balloon-guided DPC facilitates comprehensive examination of the common bile duct in the majority of patients.