Percutaneous transhepatic cholangioscopy with an ultraslim video upper endoscope with CO 2 insufflation: a feasibility study

Abstract

c o h o t ( F v fi p Cholangioscopy is performed widely for the diagnosis and management of biliary diseases. Peroral cholangioscopy (POCS) is considered to be less invasive and less time-consuming than percutaneous transhepatic cholangioscopy (PTCS). Nevertheless, PTCS is an effective alternative in cases in which an endoscopic approach to the biliary system is impossible or peroral endoscopic access to the intended duct fails. However, the poor quality of the cholangioscopes typically used for PTCS tends to result in incomplete observation and a prolonged procedure. Recently, an ultraslim video upper endoscope has been used for peroral direct cholangioscopy, offering diagnostic and therapeutic advantages over commercial peroral cholangioscopes.1-3 Furthermore, a recent report showed hat CO2 insufflation during POCS might lead to clearer images of the biliary system compared with conventional saline solution irrigation.4 In this case study, we demonstrated the technical feasibility and safety of PTCS using an ultraslim video upper endoscope in conjunction with CO2 insufflation.