CURRENT STATUS AND FUTURE PERSPECTIVE OF PERORAL CHOLANGIOSCOPY

Abstract

There are two types of peroral cholangioscopy (POCS); mother-baby peroral cholangioscopy (MB-POCS) and peroral direct cholangioscopy (PDCS). Although PDCS uses a thin endoscope, such as a nasal endoscope, its indication is limited due to technical problems. In Japan, the CHF-B290, with its superior image quality, and SpyGlass^TMDS, with its superior maneuverability and irrigation efficacy for bile and debris, are widely used as the baby scope of MB-POCS. POCS diagnosis is useful to differentiate benign and malignant biliary strictures and evaluate superficial intraductal spread of bile duct cancer. POCS treatment is useful in removing difficult biliary stones. However, the performance and types of devices for POCS diagnosis and treatment are limited. Further improvement of current devices and creation of new devices are needed to further advance POCS scopes. New advancements in POCS, such as image-enhanced endoscopy and artificial intelligence (AI) diagnostics, are emerging, and further developments are expected eventually.