Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos)

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

doi:10.1016/j.gie.2008.11.019

Cited by 142 publications

(135 citation statements)

References 14 publications

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“…To solve this problem, several support systems have been proposed, such as the use of enteroscopy overtube (5), intraduodenal balloon in parallel with the ultrathin endoscope (6), intraductal anchor systems with a special guidewire including kautz guidewire (7) and the intraductal anchor with a balloon (8,9). The latter system consists of a Fogarty balloon passed through the working channel of the ultrathin endoscope.…”

Section: A B Cmentioning

confidence: 99%

“…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%

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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: A B Cmentioning

confidence: 99%

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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“…The balloon can be anchored and fixed within a branch of the intrahepatic duct (IHD) or proximal portion of a strictured segment, so that the endoscope can be advanced into the biliary tree [6] (Fig. 1).…”

Section: Introductionmentioning

confidence: 99%

“…After advancing the balloon catheter into a branch of the IHD via the guidewire, the balloon was inflated to anchor it within the duct. The Duodenal balloon Mori et al [5] Overtube balloon Choi et al [7] Intraductal balloon Moon et al [6,12] J Hepatobiliary Pancreat Sci (2011) 18:350-356 351 endoscope was advanced over the balloon catheter by the ropeway method. An intraductal balloon passed through the endoscope may permit stable access and positioning of the endoscope within the biliary system.…”

Section: Introductionmentioning

confidence: 99%

Therapeutic role of direct peroral cholangioscopy using an ultra‐slim upper endoscope

Lee¹,

Ko²

2010

J Hepato Biliary Pancreat

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Introduction Peroral cholangioscopy provides direct visualization of the bile duct and facilitates diagnostic procedures and therapeutic intervention. The currently available mother–baby scope system is not widely used because of its disadvantages. Direct peroral cholangioscopy (POC) with a regular, ultra‐slim, upper endoscope can provide a valuable and economic solution for evaluating bile duct lesions, although its therapeutic role in biliary tract disease is uncertain. We assessed the usefulness of direct POC with an ultra‐slim endoscope for therapeutic application in patients with biliary diseases. Methods Several new techniques and accessories allow therapeutic intervention under direct POC using an ultra‐slim upper endoscope with a larger, 2‐mm working channel. Intracorporeal laser or electrohydraulic lithotripsy under direct POC is a main therapeutic intervention for patients with bile duct stones resistant to conventional endoscopic procedures. Tumor ablation therapy such as photodynamic therapy and argon plasma coagulation may be performed under direct POC. Direct POC can be applied to guide biliary interventions such as guidewire placement, stone removal, and migrated stent retrieval, using diverse accessories. Conclusion Direct POC with an ultra‐slim upper endoscope allows therapeutic intervention for patients with biliary diseases. Enhancements of the endoscope and specialized accessories are expected to expand the therapeutic role of direct POC.

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“…have been employed to access the ducts including mother-and-baby endoscopes and balloon assisted intubation [3]. Motherand-baby systems are expensive, require additional equipment, and provide poorer quality images than standard endoscopes.…”

mentioning

confidence: 99%

A novel technique for peroral direct cholangioscopy

et al. 2014

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Intraductal balloon-guided direct peroral cholangioscopy with an ultraslim upper endoscope (with videos)

Cited by 142 publications

References 14 publications

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Direct peroral cholangioscopy using an ultrathin endoscope: making technique easier

Therapeutic role of direct peroral cholangioscopy using an ultra‐slim upper endoscope

A novel technique for peroral direct cholangioscopy

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