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Medline ® Abstract for Reference 77

of 'Cholangioscopy and pancreatoscopy'

Peroral cholangioscopic diagnosis of biliary-tract diseases by using narrow-band imaging (with videos).
Itoi T, Sofuni A, Itokawa F, Tsuchiya T, Kurihara T, Ishii K, Tsuji S, Moriyasu F, Gotoda T
Gastrointest Endosc. 2007;66(4):730.
BACKGROUND: Narrow-band imaging (NBI) makes it possible to emphasize the imaging of certain features, such as mucosal structures and mucosal microvessels in GI-tract diseases. Recently, video peroral cholangioscopy (POCS) was developed as a diagnostic modality for better visualization of bile-duct lesions; however, there is no report on POCS by using NBI.
OBJECTIVE: To evaluate the clinical usefulness of POCS by using NBI for the diagnosis of biliary-tract diseases.
DESIGN: Prospective case study.
SETTING: This procedure was performed at Tokyo Medical University Hospital.
PATIENTS: Twelve consecutive patients with biliary-tract diseases, including 7 bile-duct cancers and 5 benign biliary diseases, which revealed 6 bile-duct strictures and 6 filling defects by ERCP.
INTERVENTION: All patients underwent POCS by using NBI.
MAIN OUTCOME MEASUREMENT: Efficacy and safety of this technique.
RESULTS: Twenty-one lesions were evaluated by using POCS with conventional white light imaging and NBI. Although visualization of only 2 lesions (9.5%) was "excellent" by conventional observation, visualization of 12 lesions (57.4%) was "excellent" by NBI observation. Identification of the surface structure and vessels of the lesions by NBI observation was significantly better than with conventional observation (P<.01 and P<.05, respectively).
LIMITATIONS: Maneuverability and fragility of POCS. The current POCS is not equipped with magnification.
CONCLUSIONS: POCS by using NBI may be helpful for the observation of both fine mucosal structures and tumor vessels.
Department of Gastroenterology and Hepatology, Tokyo Medical University, Tokyo, Japan.