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• W1988596985 abstract "Direct peroral cholangioscopy (DPOCS) with an ultraslim upper endoscope provides the image quality of standard endoscopy while offering the therapeutic options through a 2mm working channel. A new anchoring balloon has been marketed for its ability to assist biliary access with an ultraslim endoscope. to compare the success of performing DPOCS with an ultraslim endoscope free-hand versus using the anchoring balloon. Anchoring balloon technique: The balloon catheter was advanced over a guidewire until it reached the right or left hepatic duct. With the balloon inflated and secured in place, the duodenoscope was withdrawn to allow the ultraslim scope to pass into the bile duct over the balloon catheter. Free-hand technique: passage was aided by maneuvers including guidewire passage, forceps grasping of the bile duct, abdominal pressure and skinny retrieval balloon to serve as an anchor. A retrospective review was done to compare these two methods employed in our institution. All free-hand cases were performed before the anchoring balloon became available. 11 DPOCS using the anchoring balloon were performed on 11 patients who underwent ERCP. 23 free-hand DPOCS cases not using the anchoring balloon were performed on 17 patients. The anchoring balloon approach decreased the mean time of biliary access by approximately 4 minutes (5.9 vs. 1.8 minutes, p<0.003) and increased the rate of the endoscope reaching the hepatic bifurcation 4-fold (13% vs. 54.5%, p<0.05) (see table below). Following balloon removal, visual inspection in the moderately to markedly dilated bile ducts confirmed no residual choledocholithiasis in 4 procedures, one gallstone that was not visualized on cholangiogram, and a previous unknown retained T-tube remnant that was not radio-opaque. Bile duct biopsies were successful in 3 procedures.Tabled 1DPOCSDPOCS with anchoring balloonStatisticsNumber of procedures2311Biliary access and visualization69.6% (16/23)81.8% (9/11)NSMean passage time from mouth to common bile duct5.9 minutes1.8 minutesp<0.003Endoscope diameter 4.9 mm 5.9 mm47.8% (11/23)52.2% (12/23)63.6% (7/11)36.3% (4/11)NSEndoscope reaching the hepatic bifurcation13% (3/23)54.5% (6/11)p<0.05 Open table in a new tab DPOCS using the novel anchoring balloon can be done more successfully and efficiently than the free-hand approach. This method can reliably provide the image quality, durability and therapeutic flexibility of a standard endoscope in biliary endoscopy. Whether these advantages allow us to provide better patient care remains to be assessed further." @default.
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• W1988596985 date "2011-04-01" @default.
• W1988596985 modified "2023-10-14" @default.
• W1988596985 title "82 The Novel Biliary Anchoring Balloon Significantly Improves Efficiency and Depth of Endoscope Passage During Direct PerOral Cholangioscopy" @default.
• W1988596985 doi "https://doi.org/10.1016/j.gie.2011.03.010" @default.
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