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Direct peroral cholangioscopy using an ultraslim upper endoscope for biliary lesions

查看全文 作　　者：Shigefumi [1]Omuta;Iruru [1]Maetani;Takeo [1]Ukita;Tomoko [1]Nambu;Katsushige [1]Gon;Hiroaki [1]Shigoka;Yoshinori [1]Saigusa;Michihiro [1]Saito 高影响力作者 机构地区：[1]Division of Gastroenterology, Department of Internal Medicine, Toho University Ohashi Medical Center高影响力机构 出　　处：《Hepatobiliary & Pancreatic Diseases International》索引2014年第13卷第1期,共5页高影响力期刊 摘　　要：BACKGROUND: The development of direct peroral cholangioscopy(DPOC) using an ultraslim endoscope simplifies biliary cannulation. The conventional techniques are cumbersome to perform and require advanced skills. The recent introduction of the guidewires and balloons has improved the therapeutic outcomes. Here we describe an effective and easier method for performing DPOC using an ultraslim upper endoscope. METHODS: Indications for DPOC were the presence of stones on follow-up of patients who had previously undergone complete sphincteroplasty, including endoscopic sphincterotomy or endoscopic papillary large balloon dilatation. Fifteen patients underwent DPOC. An ultraslim endoscope was inserted perorally and was advanced into the major papilla. The ampulla of Vater was visualized by retroflexing the endoscope in the distal second portion of the duodenum, and then DPOC was performed using a wire-guided cannulation technique with an anchored intraductal balloon catheter. RESULTS: One patient failed in the treatment due to looping of the endoscope in the fornix of the stomach. Fourteen(93.3%) were successfully treated with our modified DPOC technique. Only one patient(6.7%) experienced an adverse event(pancreatitis) who responded well to conservative management. Residual stones of the common bile duct were completely removed in 3 patients. CONCLUSION: The modified method of DPOC is simple, safe and easy to access the bile duct. 关 键 词：DIRECT peroral CHOLANGIOSCOPY ultraslim UPPER ENDOSCOPE endoscopic RETROGRADE CHOLANGIOSCOPY BILIARY tract
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