title: Direct retrograde cholangioscopy with a new prototype double-bending cholangioscope.
abstract: OBJECTIVE
  Direct retrograde cholangioscopy (DRC) enables high quality video imaging of the bile ducts and allows intraductal treatment with optical control. We evaluated the feasibility, success, and complications of a new third-generation prototype cholangioscope.
  
  
  METHODS
  All consecutive patients from two tertiary endoscopy centers who had undergone DRC with the prototype were included. Indications for DRC were: evaluation of indeterminate strictures, filling defects, and complex bile duct stones. Technical success was investigated in terms of indication and treatment performed. All adverse events were recorded.
  
  
  RESULTS
  DRC with the prototype was performed in 74 patients. Therapeutic interventions included laser or electrohydraulic lithotripsy and stone removal, among others. The papilla was entered in 72/74 patients (97 %). The targeted bile duct segment was reached in 62 /74 patients (84 %), with an anchoring balloon catheter needed in 21/74 (28 %). Mean investigation time was 21 minutes (15 - 27 minutes)
  
  
  CONCLUSIONS
  DRC using the prototype is feasible, safe, and attains access to the bile ducts in almost all patients, with less need of an anchoring balloon catheter compared with the standard technique and short investigation and fluoroscopy times.
authors.affiliation: Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Beyna
authors.affiliation: Medizinische Klinik I, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Harald
authors.initials: H
authors.lastname: Farnik
authors.affiliation: Medizinische Klinik I, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Sarrazin
authors.affiliation: Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Gerges
authors.affiliation: Department of Internal Medicine, Evangelisches Krankenhaus Düsseldorf, Düsseldorf, Germany.
authors.forename: Horst
authors.initials: H
authors.lastname: Neuhaus
authors.affiliation: Medizinische Klinik I, University Hospital Frankfurt, Frankfurt, Germany.
authors.forename: Jörg G
authors.initials: JG
authors.lastname: Albert
mesh_terms: D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000000981:diagnostic imaging*; D002769:Cholelithiasis / Q000150:complications / Q000175:diagnosis / Q000628:therapy; D002779:Cholestasis / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D019723:Endoscopes / Q000009:adverse effects*; D016145:Endoscopy, Digestive System / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005858:Germany; D006801:Humans; D008096:Lithotripsy / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D017602:Lithotripsy, Laser / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results