Abstract
Cholangiocarcinomas are an important differential diagnosis of filling defects at endoscopic retrograde cholangiopancreatography (ERCP). However, the positive predictive value of cholangiography for malignant strictures is suboptimal. Direct transnasal cholangioscopy with an ultraslim dedicated gastroscope is an attractive technique for direct visualization of the lesion and sampling of targeted biopsies. The author demonstrates the case of a patient with a desmoplastic cholangiocarcinoma Bismuth type IV that is visualized with ERCP and cholangioscopy. Afterward, dual plastic stent placement is performed using the two-wire-in-one-channel method. This article is part of an expert video encyclopedia.
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