title: Peroral cholangioscopy for diagnosis and therapy of biliary tract disease using an ultra-slim gastroscope.
abstract: High-resolution video cholangioscopy is expected to improve diagnostic validity for diseases of the biliary tract. We report our experience in using an ultra-slim gastroscope for diagnosis and treatment of biliary tract disease. Cholangioscopy was attempted in 25 cases (22 patients) and succeeded in 22 cases (success rate 88%; 19 patients). Cholangiocellular carcinoma (CCC) was diagnosed by cholangioscopy in five of 10 cases (histopathologically confirmed in four), or ruled out in five. Cholangioscopy was used to detect stones in mega-choledochus (n=3), to clarify the postoperative condition of the bile ducts (n=2), to diagnose bile duct varices (n=1), and to release a dislodged self-expanding metal stent (n=1), and others. Argon plasma coagulation was successfully completed in a patient with mucin-producing adenomatosis of the bile ducts. One case of non-fatal air embolism occurred before replacing air with CO2 insufflation. In summary, peroral cholangioscopy with an ultra-slim gastroscope is feasible and helpful in selected patients, improving diagnostic validity, and offering new therapeutic interventions. This technique should only be performed using CO2 insufflation.
authors.affiliation: Department of Medicine I, Johann Wolfgang-Goethe University Hospital, Frankfurt, Germany. J.Albert@med.uni-frankfurt.de
authors.forename: J G
authors.initials: JG
authors.lastname: Albert
authors.forename: M
authors.initials: M
authors.lastname: Friedrich-Rust
authors.forename: M
authors.initials: M
authors.lastname: Elhendawy
authors.forename: J
authors.initials: J
authors.lastname: Trojan
authors.forename: S
authors.initials: S
authors.lastname: Zeuzem
authors.forename: C
authors.initials: C
authors.lastname: Sarrazin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001660:Biliary Tract Diseases / Q000175:diagnosis / Q000628:therapy; D016145:Endoscopy, Digestive System / Q000295:instrumentation* / Q000379:methods; D005260:Female; D020699:Gastroscopes; D006801:Humans; D008297:Male; D008875:Middle Aged