Applications of Cholangiopancreatoscopy in Pancreaticobiliary Diseases

Abstract

Recent advances in imaging technology provide improved direct visualization of the common bile duct (CBD) and pancreatic duct (PD) using small caliber endoscopes and thus allow a wide array of therapeutic interventions. This chapter will review the technique of cholangiopancreatoscopy (CP), indications, effectiveness, and complications as well as the current commercially available options. We will discuss various methods of diagnostic and therapeutic cholangioscopy such as intraductal tissue sampling and biopsy in patients with indeterminate biliary strictures along with its role in the management of difficult bile duct stones. Finally, we will also analyze the role of pancreatoscopy in the evaluation of suspected neoplasms of the pancreas, assessment of pancreatic duct (PD) strictures, and in the treatment of pancreatic duct stones.