Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Surg Proced. Oct 20, 2020; 10(2): 3-8
Published online Oct 20, 2020. doi: 10.5412/wjsp.v10.i2.3
Cholangioscopy-assisted guidewire placement in a malignant biliary stricture: A case report
Grace E Kim, David Yung-An Lo
Grace E Kim, Internal Medicine, University of Maryland Medical Center, Baltimore, MD 21201, United States
David Yung-An Lo, Department of Medicine, The Ohio State University College of Medicine, Ohio Gastroenterology Group, Inc, Columbus, OH 43214, United States
Author contributions: Kim GE performed literature review and drafted the manuscript; Lo DYA performed the case and revised the manuscript.
Informed consent statement: Patient was unable to reach for an informed consent despite multiple attempts.
Conflict-of-interest statement: Dr. Grace Kim and Dr. David Lo do not have any conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
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:
Corresponding author: Grace E Kim, MD, Staff Physician, Internal Medicine, University of Maryland Medical Center, 22 South Greene Street, Baltimore, MD 21201, United States.
Received: June 18, 2020
Peer-review started: June 18, 2020
First decision: July 25, 2020
Revised: August 23, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: October 20, 2020
Core Tip

Core Tip: Cholangioscopy has been described in case reports and series to facilitate guidewire placement in difficult benign biliary strictures, especially in the setting of liver transplants. Most biliary strictures are successfully traversed with standard techniques utilizing hydrophilic guidewires during endoscopic retrograde cholangiopancreatography, but challenges with difficult wire placement can occur when the biliary tree consists of multiple strictures and sharp angulations. Here we describe a case of guidewire placement through a difficult malignant biliary stricture using single operator cholangioscopy, highlighting the versatility of cholangioscopy especially in anatomically challenging patients.