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Updated: Feb 21, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Biliary intervention using SpyGlass DS cholangioscopy through a cap-attached variable-stiffness colonoscope in a
Tesshin Ban1, Hiroshi Kawakami1, Yoshimasa Kubota1
1Department of Gastroenterology and Hepatology, Faculty of Medicine, University of Miyazaki, Japan; Center for Digestive Disease, University of Miyazaki Hospital, Japan.
Abstract:
The SpyGlass DS system is currently used as a direct video cholangioscope for biliary diagnostic and therapeutic procedures. In general, the SpyGlass DS cholangioscope is passed through the working channel of a duodenoscope and inserted into a bile duct via duodenal papilla. However, the procedure has been challenging in patients with altered gastrointestinal anatomy due to the retrograde route through a potentially tortuous afferent limb. A therapeutic colonoscope with variable stiffness can offer alternative guidance for SpyGlass DS cholangioscope in patients with surgically altered gastrointestinal anatomy.
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