Abstract
Peroral cholangioscopy (PCS) with endoscopic papillary dilation(EPD)was performedin combination with intraductal administration of a nitrite for the purpose of inserting aperoral cholangioscope, equipped with both a biopsy channel and anguration system, intothe bile duct without endoscopic sphincterotomy. A cholangioscope was successfully inserted into the bile duct as many as 90%of thecases examined, .whereas the papilla could not be observed in the front view in allunsuccessful cases while keeping an adequate distance from the papilla. After endoscopicpapillary dilation, blond oozing vvas observed in all cases, but did not require any hemos-tatic means, or was not worsened by insertion of a cholangioscope. Acute pancreatitis occurs as a complication in 15%, but Was remitted by conservativetreatment in all cases. Since PAS is mainly for making a diagnosis, it is desirable that suchexamination is accornpanished without damage to the original physiological function. EPD in combination with intraductal administration of a nitrite was considered to lieauseful technique fcr PCS, including hicpsy under direct vision.
