USEFULNESS OF PROBE-BASED CONFOCAL LASER ENDOMICROSCOPY UNDER DIRECT VIEW OF PERORAL CHOLANGIOSCOPY FOR BILIARY STRICTURES(WITH A VIDEO)

Abstract

Biliary stricture is frequently encountered in routine practice, and at times a distinction between benign and malignant biliary strictures is challenging. Confocal laser endomicroscopy (CLE) is expected to overcome this situation. This method generates real-time microscopic images of the bile duct tissue by using a dedicated confocal miniprobe that enables in vivo histological assessment, termed as “virtual biopsy”. However, these procedures are often performed under fluoroscopic guidance through a catheter during ERCP. Therefore, there is uncertainty regarding the proper application of the confocal miniprobe to the site of interest. The confocal miniprobe may be applied accurately to the site of interest using peroral cholangioscopy (POCS). Here, we discuss the usefulness and procedure of probe-based CLE under the direct view of POCS for biliary strictures.