Comparison of peroral and percutaneous cholangioscopy

The clinical applications of peroral and percutaneous cholangioscopies are discussed, and the indications, advantages, disadvantages and therapeutic results compared. Peroral cholangioscopy (PCS) performed between January 1986 and April 1989 with the most advanced mother and baby 'scope system was compared with percutaneous cholangioscopic procedures such as PTCS, POCS and PTCCS done in the same period. PCS was done to remove common bile duct stones using electrohydraulic lithotripsy and to diagnose bile duct tumors with effective biopsy studies. Removal of intrahepatic bile duct stones was successfully performed with percutaneous cholangioscopy compared with the PCS procedure. For direct visualization of common bile duct tumors, PCS was the preferred approach for tumors located in the middle CBD to the liver hilus. On the other hand, percutaneous approaches had a good indication for the lesions in the distal CBD. Thus, the best approach for each lesion should be selected for effective diagnosis and treatment.