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Medline ® Abstract for Reference 57

of 'Rare complications of endoscopic retrograde cholangiopancreatography (ERCP)'

Peroral cholangioscopy for diagnosis and therapy of biliary tract disease using an ultra-slim gastroscope.
Albert JG, Friedrich-Rust M, Elhendawy M, Trojan J, Zeuzem S, Sarrazin C
Endoscopy. 2011;43(11):1004.
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.
Department of Medicine I, Johann Wolfgang-Goethe University Hospital, Frankfurt, Germany. J.Albert@med.uni-frankfurt.de