Peroral direct cholangioscopy using an ultra-slim gastroscopy assisted by a snare / 中华消化内镜杂志

ABSTRACT

Objective To evaluate the feasibility of diagnostic and therapeutic peroral direct cholan-gioscopy (PDCS)using an ultra-slim upper endoscopy assisted by a snare.Methods Between November 2014 and January 2015,8 patients underwent PDCS with assistance of an ultra-slim endoscopy.After endo-scopic papillary balloon dilation,the duodenoscopy was withdrew,an ultra-slim endoscopy was inserted di-rectly into the biliary tract assisted by a snare,and biopsy or laser lithotripsy was performed.The snare was closed tightly in the bent portion of the scope,and the snare was pulled while scope shaft had to become the form of U loop by counterclockwise rotation,in order to advance the scope into common bile duct.Results PDCS succeeded in all eight cases,one common hepatic duct adenoma was diagnosed by biopsy,and con-firmed by surgery;one benign biliary stricture was diagnosed by PDCS;laser lithotripsy was successfully per-formed in 4 patients with large CBD stones;bile duct clearance was verified by PDCS in two patients who was suspected of residual CBD stones.No perforation,bleeding or post-operative pancreatitis was found.Con-clusion PDCS using an ultra-slim gastroscopy assisted by a snare is a safe,simple and practical procedure in the diagnosis and treatment of biliary tract diseases.