| Abstract: | To date, peroral cholangioscopy (POCS) with working channel for biopsy is a less than an essential means for endoscopic diagnosis of bile duct lesions. One of these reasons is that the durability of the baby scope is much improved, too delicate for use on tough lesions. Furthermore, in operable cases, it has a major disadvantage in that we cannot observe the proximal site of stricture. In this study, we introduced new methods to observe and perform the biopsy at proximal site of stricture using 10Fr plastic stent. After this method, we performed observation of proximal site of stricture without dilation and could diagnose precise incision line preoperatively in all cases. Importantly, all procedures were done within one week from the first endoscopic retrograde cholangiopancreatography (ERCP). Although further investigation and development of baby scopes are necessary, POCS using 10Fr plastic stent will make it possible to evaluate the hepatic site of spreading cancer in patients with middle or lower bile duct cancer. |
