Post written by Carlos Robles-Medranda, MD, FASGE, AGAF, from the Endoscopy Division, Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador. We describe a case of a patient cared for in a medical facility abroad (Colombia) who presented with jaundice and proximal common bile duct stenosis detected with MRCP. EUS identified a homogeneous hypoechoic lesion localized at …
Tag: cholangioscopy
Bile duct tissue acquisition by cholangioscopy-guided cryobiopsy technique: first-in-human application
Post written by Jan Peveling-Oberhag, MD, from the Department of Gastroenterology, Klinikum Stuttgart, Stuttgart, Germany. The cryobiopsy technique is a new method for tissue extraction that allows for extraction of high tissue amounts with a minimal diameter endoscopic instrument. Forceps biopsies through the very small working channel of a cholangioscope are oftentimes unrepresentative. In this …
Editor’s Choice: Identification of patients with malignant biliary strictures using a cholangioscopy-based deep learning artificial intelligence (with video)
GIE Senior Associate Editor David L. Diehl, MD, highlights this article from the February issue: “Identification of patients with malignant biliary strictures using a cholangioscopy-based deep learning artificial intelligence (with video)” by Neil B. Marya, MD, et al. The assessment of indefinite biliary strictures is difficult because results of intraductal biopsy and cytologic brushing can be inconclusive. It …
Cholangioscopic diagnosis of hemobilia: an unusual case of left hepatic portal hypertension by plasma cell tumor
Post written by Kyosuke Goda, MD, and Yusuke Hashimoto, MD, MMA, from the National Cancer Center, Hospital East Hepatobiliary Pancreatic Oncology, Chiba, Japan. A 68-year-old man with a history of diabetes mellitus was referred to our institution for evaluation of a bulky tumor in the head of the pancreas. Abdominal CT revealed a large hyperdense …
Cholangioscopy-guided double-guidewire technique for complex malignant hilar obstruction
Post written by Margaret G. Keane, MBBS, MSc, from the Department of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland, USA. A 77-year-old man presented to our institution with jaundice, right upper quadrant pain, loss of appetite, and weight loss. Blood tests confirmed a raised Bilirubin (8.6 mg/dl), abnormal LFTs (Alkaline phosphatase 320 IU/L, AST …
Cholangioscopy in primary sclerosing cholangitis
Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. This is a case series of 5 patients, demonstrating several unique and varied benign features of PSC. We describe a novel phenotypic classification of benign features, whereby we categorize findings into …
Continue reading Cholangioscopy in primary sclerosing cholangitis
A rare case of hepatocellular carcinoma with bile duct invasion diagnosed by peroral cholangioscopy
Post written by Masanori Kobayashi, MD, PhD, from the Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University (TMDU), Tokyo, Japan. This video shows a rare case where hepatocellular carcinoma (HCC) mainly progressing to the bile duct was observed by peroral cholangioscopy (POCS). HCC, in which a primary tumor cannot be detected in the …
Cholangioscopy-guided removal of a proximally migrated biliary stent using a modified standard polypectomy snare
Post written by Moamen Gabr, MD, MSc, from the Division of Digestive Diseases and Nutrition, University of Kentucky, Lexington, Kentucky. A 72-year-old male with diagnosis of pancreatic head adenocarcinoma requiring endoscopic biliary stent placement 2 weeks prior to admission presented with signs of biliary obstruction. Imaging showed proximal migration of a previously placed biliary stent. …
Cholangioscopy in primary sclerosing cholangitis: a case series of dominant strictures and cholangiocarcinoma
Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. This video case series describes and differentiates between the cholangioscopic features of benign dominant strictures and cholangiocarcinoma in PSC. It demonstrates that the morphologic features of cholangiocarcinoma in PSC is varied. …
Vascularity can distinguish neoplastic from non-neoplastic bile duct lesions during digital single-operator cholangioscopy
Post written by Carlos Robles-Medranda, MD, from the Gastroenterology and Endoscopy, Instituto Ecuatoriano de Enfermedades Digestivas, Guayaquil, Ecuador. Accurately diagnosing indeterminate biliary lesions on clinical practice is a challenging task. Endoscopists may use Digital single operator cholangioscopy (DSOC) to evaluate those lesions, acquire histologic specimens, and to guide clinical management. Various DSOC classification systems and …
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