Gut Liver.  2024 Mar;18(2):358-364. 10.5009/gnl230163.

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

• Lee WM
• Moon JH
• Lee YN
• Min CW
• Shin IS
• Myeong JH
• Kim HK
• Yang JK
• Lee TH

• KMID: 2553858
• DOI: http://doi.org/10.5009/gnl230163

Abstract

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.

Keyword

Biliary tract neoplasms; Intrahepatic bile duct; Biliary tract diseases; Intraductal lithotripsy; Peroral cholangioscopy