Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video).
BACKGROUND
Peroral cholangioscopy (POCS) is useful for the diagnosis of various bile duct lesions. However, it is often difficult to obtain clear images because of bile or biliary sludge in the bile duct, even after vigorous irrigation of the bile duct with saline solution. Therefore, this study investigated whether inflation with carbon dioxide (CO(2)) yields clearer images of the bile duct than conventional saline solution irrigation during POCS.


OBJECTIVE
To evaluate the clinical utility and safety of CO(2) insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation.


METHODS
A single center.


METHODS
Case-control study.


METHODS
Nineteen patients with suspected biliary diseases.


METHODS
CO(2) insufflation into the bile duct during POCS.


METHODS
The quality and safety of this method.


RESULTS
The quality of the images of the bile duct lumen with CO(2) insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P < .05) and color (P < .05). In particular, extremely clear images could be obtained from the middle part of common bile duct to the right and left hepatic duct. No serious POCS-related complications occurred. There was no significant change in the venous partial pressure of the CO(2) level during the procedure.


CONCLUSIONS
The number of patients examined was small.


CONCLUSIONS
CO(2) insufflation is useful for obtaining clear images of the bile duct during POCS, which makes it possible to determine the qualitative diagnosis and the extent of various bile duct lesions.
Ueki
Toru
T
Department of Internal Medicine, Fukuyama City Hosptial, Japan. torueki0730@yahoo.co.jp
Mizuno
Motowo
M
Ota
Shigeru
S
Ogawa
Tsuneyoshi
T
Matsushita
Hiroshi
H
Uchida
Daisuke
D
Numata
Norifumi
N
Ueda
Asuka
A
Morimoto
Yuuki
Y
Kominami
Yoko
Y
Nanba
Shintaro
S
Kurome
Manabu
M
Ohe
Hirotoki
H
Nakagawa
Masahiro
M
Araki
Yasuyuki
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017734:Bile Ducts, Extrahepatic; D001660:Biliary Tract Diseases / Q000175:diagnosis*; D002245:Carbon Dioxide; D016022:Case-Control Studies; D016145:Endoscopy, Digestive System; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D007507:Therapeutic Irrigation; D014741:Video Recording
D002245:Carbon Dioxide