Abstract
The development and improvement of peroral cholangioscope have been made since the technical establishment of endoscopic papillotomy. Our best concern is how to introduce the scope directly into the common bile duct in the papillotomized patients. After several processes of trial and error. We have reached at the Vth stage of devel-opmental process with successful improvement of the cholangioscope itself and satisfactory establishment of methodology, of introduction of the scope into the common bile duct, which is considered as the most efficient method so far. That is a combination use of the main scope and supplemental devices such as balloon-catheter, inner guiding tube and outer guiding tube. The most characteristic point of this method is to detain the outer guiding tube into the common bile duct of the papillotomized patients. This procedure has ensured easy and repeated introduction not only of the main scope cholangioscope, but also other several types of forceps for biopsy or removal of intrahepatic bile stones. With this present pro-cedure, as a matter of fact, we have succeeded in removing intrahepatic bile stones in 3 cases so far. We will introduce the present state of peroral cholangioscope, reporting a clinical case of intrahepatic cholelithiasis which was successfully treated by this procedure.
