Current status of peroral cholangioscopy in biliary tract diseases  

作　　者：Stefania Ghersi Lorenzo Fuccio Marco Bassi Carlo Fabbri Vincenzo Cennamo 

机构地区：[1]Unit of Gastroenterology and Digestive Endoscopy, AUSL Bologna, Bellaria-Maggiore Hospital [2]Department of Medical and Surgical Sciences, S.Orsola-Malpighi Hospital, University of Bologna

出　　处：《World Journal of Gastrointestinal Endoscopy》2015年第5期510-517,共8页世界胃肠内镜杂志（英文版）（电子版）

摘　　要：Peroral cholangioscopy(POC) is an important tool for the management of a selected group of biliary diseases. Because of its direct visualization, POC allows targeted diagnostic and therapeutic procedures. POC can be performed using a dedicated cholangioscope that is advanced through the accessory channel of a duodenoscope or via the insertion of a small-diameter endoscope directly into the bile duct. POC was first described in the 1970 s, but the use of earlier generation devices was substantially limited by the cumbersome equipment setup and high repair costs. For nearly ten years, several technical improvements, including the single-operator system, high-quality images, the development of dedicated accessories and the increased size of the working channel, have led to increased diagnostic accuracy, thus assisting in the differentiation of benign and malignant intraductal lesions, targeting biopsies and the precise delineation of intraductal tumor spread before surgery. Furthermore, lithotripsy of difficult bile duct stones, ablative therapies for biliary malignancies and direct biliary drainage can be performed under POC control. Recent developments of new types of conventional POCs allow feasible, safe and effective procedures at reasonable costs. In the current review, we provide an updated overview of POC, focusing our attention on the main current clinical applications and on areas for future research.Peroral cholangioscopy （POC） is an important toolfor the management of a selected group of biliarydiseases. Because of its direct visualization, POC allowstargeted diagnostic and therapeutic procedures. POCcan be performed using a dedicated cholangioscopethat is advanced through the accessory channel of aduodenoscope or via the insertion of a small-diameterendoscope directly into the bile duct. POC was firstdescribed in the 1970s, but the use of earlier generationdevices was substantially limited by the cumbersomeequipment setup and high repair costs. For nearlyten years, several technical improvements, includingthe single-operator system, high-quality images, thedevelopment of dedicated accessories and the increasedsize of the working channel, have led to increaseddiagnostic accuracy, thus assisting in the differentiationof benign and malignant intraductal lesions, targetingbiopsies and the precise delineation of intraductaltumor spread before surgery. Furthermore, lithotripsyof difficult bile duct stones, ablative therapies forbiliary malignancies and direct biliary drainage can beperformed under POC control. Recent developmentsof new types of conventional POCs allow feasible, safeand effective procedures at reasonable costs. In thecurrent review, we provide an updated overview ofPOC, focusing our attention on the main current clinicalapplications and on areas for future research.

关 键 词：Peroral CHOLANGIOSCOPY BILIARY TRACT disease Direct visualization INDETERMINATE BILIARY STRICTURES Bileduct STONES 

分 类 号：R575.6[医药卫生—消化系统]