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World J Gastrointest Endosc. Feb 16, 2022; 14(2): 63-76
Published online Feb 16, 2022. doi: 10.4253/wjge.v14.i2.63
Peroral cholangioscopy: Update on the state-of-the-art
Amith Subhash, James L Buxbaum, James H Tabibian
Amith Subhash, Department of Gastroenterology, Kirk Kerkorian School of Medicine at UNLV, Las Vegas, NV 89102, United States
James L Buxbaum, Division of Gastrointestinal and Liver Diseases, Keck School of Medicine of USC, Los Angeles, NV 90033, United States
James H Tabibian, David Geffen School of Medicine at UCLA, Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA 91342, United States
James H Tabibian, Vatche and Tamar Manoukian Division of Digestive Diseases, David Geffen School of Medicine at UCLA, Los Angeles, NV 90095, United States
Author contributions: Subhash A, Buxbaum JL, and Tabibian JH have all been involved in drafting the manuscript and/or making critical revisions; Subhash A, Buxbaum JL, and Tabibian JH meet the criteria for authorship established by the International Committee of Medical Journal Editors and approve the final manuscript for publication.
Conflict-of-interest statement: There are no conflicts of interest to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: James H Tabibian, MD, PhD, Associate Professor, David Geffen School of Medicine at UCLA, Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, 2B-182 Olive View Dr, Sylmar, CA 91342, United States. jtabibian@dhs.lacounty.gov
Received: June 30, 2021
Peer-review started: June 30, 2021
First decision: July 29, 2021
Revised: August 25, 2021
Accepted: January 17, 2022
Article in press: January 17, 2022
Published online: February 16, 2022
Processing time: 224 Days and 15.5 Hours
Abstract

Peroral cholangioscopy (POC) is an endoscopic procedure that allows direct intraductal visualization of the biliary tract. POC has emerged as a vital tool for indeterminate biliary stricture evaluation and treatment of difficult biliary stones. Over several generations of devices, POC has fulfilled additional clinical needs where other diagnostic or therapeutic modalities have been inadequate. With adverse event rates comparable to standard endoscopic retrograde cholangioscopy and unique technical attributes, the role of POC is likely to continue expand. In this frontiers article, we highlight the existing and growing clinical applications of POC as well as areas of ongoing research.

Keywords: Peroral cholangioscopy; SpyGlassTM; Difficult bile duct stones; Indeterminate biliary strictures; Cholangioscope-guided biopsy; Cholangioscope-guided lithotripsy

Core Tip: Cholangioscopy is an endoscopic technique that was first developed in the 1970s as a minimally-invasive modality for the evaluation of various biliopancreatic pathologies. Since the advent of the digital single-operator cholangioscopy (D-SOC) in 2015 as well as other, complementary advancements in the field, diagnostic and therapeutic applications have further expanded. Herein, we discuss the various current applications of cholangioscopy, with a focus on D-SOC, and areas of ongoing research to better understand potential future directions.