Biliary Tract & Pancreas; Usefulness of Intraductal Endoscopy for Pancreaticobiliary Disease

Kim, Young Soo; Hahm, Ki Baik; Kim, Jin Hong; Cho, Sung Woo; Hong, Sa Joon; Moon, Young Soo; Lee, Kwang Jae

Abstract

BACKGROUND/AIMS
The aim of this study was to evaluate the usefulness of intraductal endoscopy in pancreaticobiliary tract disease by means of percutaneous cholangioscopy(PCS), peroral cholangioscopy(POCS) and peroral pancteatoscopy(POPS).
METHODS
PCS was performed in 33 patients, including 24 patients with biliary tract stones, and 8 patients with malignant biliary tract disease, and one with villous adenoma of common bile duct(CBD), POCS was performed in 5 patients, including two with cholangiocarcinoma, two with icteric hepatoma and one with benign stenosis of bile duct. POPS performed in 6 patients, ineluding 3 patients with chronic pancreatitis, two with pancreatic cancer and one with mucinous ductal ectasia.
RESULTS
1. Complete removal of the stones was achieved in 22 of 24 patie~nts(91.7%). 2. Accuracy rate of forceps biopsy in PCS was achieved 13 fo 14 patients(92.9%). 3. Success rate of therapeutic PCS was 100%. 4. Accuracy rate of forceps biopsy in POCS was achieved 3 of 5 patients(60%). 5. Diagnostic gain of POPS was achieved 5 of 6 patients(83.3%). 6. There was no serious complications with only mild complications in 3 patients, including mild bleeding in 2 patients and cholangitis in only one.
CONCLUSIONS
Intraductal endoscopy of biliary tract, including PCS and POCS were useful diagnostic and therapeutic methods with advantages of direct visualization of intraductal disease and POPS using ultrathin pancreatoscope could provide direct assessment of the pancreatic duct.