Peroral cholangioscopic diagnosis of biliary-tract diseases by using narrow-band imaging (with videos).
BACKGROUND
Narrow-band imaging (NBI) makes it possible to emphasize the imaging of certain features, such as mucosal structures and mucosal microvessels in GI-tract diseases. Recently, video peroral cholangioscopy (POCS) was developed as a diagnostic modality for better visualization of bile-duct lesions; however, there is no report on POCS by using NBI.


OBJECTIVE
To evaluate the clinical usefulness of POCS by using NBI for the diagnosis of biliary-tract diseases.


METHODS
Prospective case study.


METHODS
This procedure was performed at Tokyo Medical University Hospital.


METHODS
Twelve consecutive patients with biliary-tract diseases, including 7 bile-duct cancers and 5 benign biliary diseases, which revealed 6 bile-duct strictures and 6 filling defects by ERCP.


METHODS
All patients underwent POCS by using NBI.


METHODS
Efficacy and safety of this technique.


RESULTS
Twenty-one lesions were evaluated by using POCS with conventional white light imaging and NBI. Although visualization of only 2 lesions (9.5%) was "excellent" by conventional observation, visualization of 12 lesions (57.4%) was "excellent" by NBI observation. Identification of the surface structure and vessels of the lesions by NBI observation was significantly better than with conventional observation (P < .01 and P < .05, respectively).


CONCLUSIONS
Maneuverability and fragility of POCS. The current POCS is not equipped with magnification.


CONCLUSIONS
POCS by using NBI may be helpful for the observation of both fine mucosal structures and tumor vessels.
Itoi
Takao
T
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.
Sofuni
Atsushi
A
Itokawa
Fumihide
F
Tsuchiya
Takayoshi
T
Kurihara
Toshio
T
Ishii
Kentaro
K
Tsuji
Shujiro
S
Moriyasu
Fuminori
F
Gotoda
Takuji
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D003937:Diagnosis, Differential; D020776:Endoscopes, Gastrointestinal; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015203:Reproducibility of Results; D014741:Video Recording / Q000379:methods*