Abstract
Peroral cholangiopancreatoscopy (PCPS) and peroral direct cholangioscopy (PDCS) are discussed. PCPS using a mother and babyscope (Olympus Co.)was attempted on 8 cases. The duct systems were observed in 7 cases; cholangioscopy in 5, pancreatoscopy in 1 and cholangiopancreatoscopy in 1 case. Concerning to the babyscope, it is required to develop the bending system and the biopsy channel for further step. In order to supplement these weak point of the babyscope, we developed new technique without using the babyscope, that is, direct observation of the bile duct (peroral direct cholangioscopy, (PDCS)). PDCS with using forward-viewing fiberscope GIF-P2 was performed in 6 cases after endoscopic papillotomy. In 4 out of 6 cases the tip of the endoscope was inserted directly into the common bile duct through the incised papilla. The common bile duct could be observed clearly compared with the babyscope by this method. Furthermore, in one case a stone in the common bile duct was caught by a basket catheter under direct visual control and removed from the duct to the duodenum. At present time authors have considered a role of peroral cholangiopancreatoscopy as follows. PCPS is useful for endoscopic observation of the pancreatic and the bile duct with or without endoscopic papillotomy. PDCS is useful for endoscopic observation and treatment of the bile duct after endoscopic papillotomy.
