Overtube-balloon–assisted direct peroral cholangioscopy by using an ultra-slim upper endoscope (with videos)

Choi, Hyun Jong; Ko, Bong Min; Hong, Su Jin; Koo, Hyun Cheol; Cheon, Young Koog; Cho, Young Deok; Lee, Joon Seong; Lee, Moon Sung; Shim, Chan Sup

doi:10.1016/j.gie.2008.08.043

Cited by 112 publications

(92 citation statements)

References 12 publications

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“…Even when access is achieved, it is difficult to advance the ultrathin endoscope to the biliary confluence, due to the formation of loops in the stomach and duodenum. To solve this problem several systems have been investigated such as overtubes (5), the use of intraduodenal balloon (6), intraductal anchoring systems with special guide wires (7) and intraductal balloon-assisted cholangioscopy (8).…”

Section: Introductionmentioning

confidence: 99%

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Sola-Vera

Uceda

Cuesta

et al. 2014

Rev. esp. enferm. dig.

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Background: Cholangioscopy is a useful tool for the study and treatment of biliary pathology. Ultrathin upper endoscopes allow direct peroral cholangioscopy (DPC) but have some drawbacks.Objective: The aim of the study was to evaluate the success rate of DPC with an ultrathin endoscope using a balloon catheter to reach the biliary confluence.Material and methods: Prospective observational study. An ultrathin endoscope (Olympus XP180N, outer diameter 5.5 mm, working channel 2 mm) was used. To access the biliary tree, free-hand technique was used. To reach the biliary confluence an intraductal balloon catheter (Olympus B5-2Q diameter 1.9 mm) and a 0.025 inch guide wire was used. In all cases sphincterotomy and/ or sphincteroplasty was performed. The success rate was defined as the percentage of cases in which the biliary confluence could be reached with the ultrathin endoscope.Results: Fifteen patients (8 men/7 women) were included. Mean age was 77.7 ± 10.8 years (range 45-91). The indications for cholangioscopy were suspected bile duct stones (n = 9), electrohydraulic lithotripsy for the treatment of difficult choledocholithiasis (n = 5) and evaluation of biliary stricture (n = 1). Access to the bile duct was achieved in 14/15 cases (93.3 %). Biliary confluence was reached in 13/15 cases (86.7 %). One complication was observed in one patient (oxigen desaturation).Conclusions: DPC with an ultrathin endoscope can be done with the free-hand technique. Intraductal balloon-guided DPC allows full examination of the common bile duct in most cases.

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Section: Introductionmentioning

confidence: 99%

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Sola-Vera

Uceda

Cuesta

et al. 2014

Rev. esp. enferm. dig.

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“…Looping can sometimes be prevented with the use of an overtube as demonstrated by Choi et al in their case series of 12 patients with various biliary diseases. 16 Overtube-balloon-assisted direct cholangioscopy was performed successfully in 10 of the 12 patients (83.3%). In another series of 14 patients, Tsou et al demonstrated successful introduction of the ultra-slim endoscope into the bile ducts of all the patients using the overtube balloon-assisted technique.…”

Section: Ultra-slim Endoscopesmentioning

confidence: 95%

Per-oral cholangioscopy

Monga

Ramchandani²,

Reddy³

2011

jig

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Direct endoscopic views of bile duct have been described in literature since the 1970s. Since then rapid strides have been made with the advent of technologically advanced systems with better image quality and maneuverability. The single operator semi-disposable per-oral cholangioscope and other novel methods such as the cholangioscopy access balloon are likely to revolutionize this field. Even though cholangioscopy is currently used primarily for characterization of indeterminate strictures and management of large bile duct stones, the diagnostic and therapeutic indications are likely to expand in future. The following is an overview of the currently available per-oral cholangioscopy equipments, indications for use and future directions.

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“…[4][5][6][7][8] Here, we describe the first report of PDCS-guided endoscopic biopsy and photodynamic therapy (PDT) for recurrent HCC with intraductal tiny nodular tumor growth.…”

Section: 3mentioning

confidence: 99%

Peroral Direct Cholangioscopic-Guided Biopsy and Photodynamic Therapy Using an Ultraslim Upper Endoscope for Recurrent Hepatocellular Carcinoma with Intraductal Tiny Nodular Tumor Growth

Noh¹,

Park²,

Kim³

et al. 2010

Gut Liver

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Bile-duct invasion is rare in patients with hepatocellular carcinoma (HCC). We report a case that received peroral direct cholangioscopy (PDCS)-guided endoscopic biopsy and photodynamic treatment (PDT) for recurrent HCC with intraductal tiny nodular tumor growth. A 64-year-old woman presented with recurrent right upper-quadrant pain. Six months previously she had been diagnosed with HCC with bile-duct invasion in the right anterior segment and had received right anterior segmentectomy. On pathological examination, the margin of resection was clear, but macroscopic bile-duct invasion was noted. On admission, magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography (ERCP) revealed a 0.5-cm-sized polypoid mass at the hilar portion. ERCP-guided biopsy failed, and an ampullary stricture was noted. PDCS-guided endoscopic biopsy was thus performed, and histopathology of the retrieved specimen revealed HCC. The patient submitted to PDT. There was no procedure-related complication. After 1 month of PDT the polypoid lesion and scar change at the hilar lesion had disappeared. (Gut Liver 2010; 4:398-401)

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Overtube-balloon–assisted direct peroral cholangioscopy by using an ultra-slim upper endoscope (with videos)

Cited by 112 publications

References 12 publications

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Per-oral cholangioscopy

Peroral Direct Cholangioscopic-Guided Biopsy and Photodynamic Therapy Using an Ultraslim Upper Endoscope for Recurrent Hepatocellular Carcinoma with Intraductal Tiny Nodular Tumor Growth

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