A snare-assisted peroral direct choledochoscopy and pancreatoscopy using an ultra-slim upper endoscope: A case series study.
OBJECTIVE
To evaluate the feasibility, effectiveness and safety of a new snare-assisted peroral direct choledochoscopy/pancreatoscopy (PDCPS) technique.


METHODS
From November 2014 through December 2016, 20 consecutive patients with indications for PDCPS were enrolled in this observational study. Endoscopic retrograde cholangiography was initially performed using a conventional duodenoscope, and endoscopic papillary balloon dilation was performed. Next, an ultra-slim endoscope was inserted to perform the PDCPS; a snare tightened around the end of the scope's bending section facilitated its entry into the common bile duct (CBD). The primary endpoint was the overall success rate of the PDCPS procedure (successful biliary intubation and visualization of the area of interest) and the time for biliary intubation with the ultra-slim upper endoscope.


RESULTS
Participants (11 men and 9 women; mean age, 72.2 years [range, 41-93 years]) had CBD adenoma (n=1), large CBD stones after failed extraction/lithotripsy treatment (n=13), CBD strictures (n=4), pancreatic duct tumor (n=1) or pancreatic duct dilation (n=1). The success rate was 95%. The mean intubation time was 18min (range, 4-57min). No adverse events were reported.


CONCLUSIONS
A snare-assisted PDCPS technique appears to be technically feasible, effective and safe for both diagnostic and therapeutic applications.
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China. Electronic address: huangyonghui@medmail.com.cn.
Yong-Hui
YH
Huang
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China.
Hong
H
Chang
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China.
Wei
W
Yao
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China.
Yao-Peng
YP
Zhang
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China.
Ke
K
Li
Department of Gastroenterology and Hepatology, Peking University Third Hospital, Beijing, China.
Ye
Y
Wang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002681:China; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D042882:Gallstones / Q000175:diagnosis* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010182:Pancreatic Diseases / Q000175:diagnosis* / Q000628:therapy*; D011237:Predictive Value of Tests; D016896:Treatment Outcome
Biliary tract diseases; Peroral direct cholangioscopy (PDCS); Snare; Ultra-slim upper endoscope