Peroral cholangioscopy in choledocho-duodenostomy--patients using the pediatric fiberscope

Area of Science:

• Gastroenterology
• Endoscopy
• Biliary Medicine

Background:

• Bilio-digestive anastomoses can present challenges for endoscopic visualization.
• Existing methods may have limitations in accessing and intervening within the biliary tree post-surgery.

Purpose of the Study:

• To evaluate the feasibility and efficacy of peroral cholangioscopy using a pediatric endoscope in patients with wide-open bilio-digestive anastomoses.
• To assess the diagnostic and therapeutic potential of this technique.

Main Methods:

• Peroral cholangioscopy was performed using the pediatric endoscope GIF-P2.
• The procedure allowed visualization of the common bile duct from the papilla to hepatic duct tributaries.
• An instrumentation channel facilitated stone mobilization, food particle extraction (cholangiophytiasis), and guided biopsies.

Main Results:

• The pediatric endoscope was easily utilized in patients with wide-open bilio-digestive anastomoses.
• Successful visualization of the entire common bile duct was achieved.
• The technique enabled therapeutic interventions, including stone and food particle removal, and tissue sampling.

Conclusions:

• Peroral cholangioscopy with a pediatric endoscope is a promising and easily performed method for evaluating and treating biliary conditions in patients with bilio-digestive anastomoses.
• This approach offers a minimally invasive option for managing complications such as retained stones and food impaction.