Usefulness of Direct Peroral Cholangioscopy Using a Multibending Ultraslim Endoscope for the Management of Intrahepatic Bile Duct Lesions (with Videos)

• Published in: Gut and liver 2024-03, Vol.18 (2), p.358
• Main Authors: Won Myung Lee, Jong Ho Moon, Yun Nah Lee, Chang Wook Min, Il Sang Shin, Jun Ho Myeong, Hee Kyung Kim, Jae Kook Yang, Tae Hoon Lee
• Format: Article
• Language: Korean
• Subjects: Biliary tract diseases; Biliary tract neoplasms; Intraductal lithotripsy; Intrahepatic bile duct; Peroral cholangioscopy
• ISSN: 1976-2283

Background/Aims: Peroral cholangioscopy (POC) has been used to assess intrahepatic duct (IHD) lesions but with a limited role. A new multibending (MB) ultraslim endoscope has been designed to improve POC performance. We evaluated the usefulness of POC using the MB ultraslim endoscope for the management of IHD lesions. Methods: Between March 2017 and March 2020, 22 patients underwent direct POC using the MB ultraslim endoscope for IHD lesions documented by previous imaging or cholangiopancreatography. The primary outcome was technical success of POC, and secondary outcomes were technical success of POC-guided interventions, median procedure time, and POC-related adverse events. Results: The technical success rate for POC using the MB ultraslim endoscope for IHD lesions was 95.5% (21/22). Free-hand insertion was successful in 95.2% (20/21). The overall technical success rate for POC-guided intervention was 100% (21/21), including nine diagnostic and 12 therapeutic procedures (eight direct stone removal and four intraductal lithotripsies). The median procedure time was 29 minutes (range, 9 to 79 minutes). There were no procedure-related adverse events. Conclusions: Direct POC using the MB ultraslim endoscope allows direct visualization of IHD lesions and may be useful for diagnosis and therapeutic management in selected patients. (Gut Liver 2024;18:358-364)