Cholangioscopy for special applications: primary sclerosing cholangitis, liver transplant, and selective duct access

Gastrointest Endosc Clin N Am. 2009 Oct;19(4):579-86. doi: 10.1016/j.giec.2009.06.003.


Cholangioscopy is gaining renewed interest and gradually expanded use as a result of recent technical improvements in endoscopes and accessories, coupled with shortcomings in the accuracy of currently available techniques for biliary sampling and diagnosis. Challenging clinical dilemmas that may benefit from its application include early diagnosis of cholangiocarcinoma in the setting of primary sclerosing cholangitis, early identification of biliary infection or ischemia following orthotopic liver transplantation, and selective duct access with wires and other devices during therapeutic endoscopic retrograde cholangiopancreatography. Preliminary data suggest that cholangioscopy has significant utility in assessment and management of primary sclerosing cholangitis. Applications in posttransplant patients and for selective duct access remain minimally defined and used.

Publication types

  • Review

MeSH terms

  • Bile Duct Neoplasms / diagnosis
  • Bile Duct Neoplasms / therapy
  • Bile Ducts, Intrahepatic* / pathology
  • Bile Ducts, Intrahepatic* / surgery
  • Cholangiocarcinoma / diagnosis
  • Cholangiocarcinoma / therapy
  • Cholangiopancreatography, Endoscopic Retrograde / instrumentation
  • Cholangiopancreatography, Endoscopic Retrograde / methods*
  • Cholangitis, Sclerosing / diagnosis*
  • Cholangitis, Sclerosing / therapy
  • Humans
  • Ischemia / diagnosis
  • Ischemia / etiology
  • Liver / blood supply
  • Liver / pathology
  • Liver Diseases / diagnosis
  • Liver Diseases / etiology
  • Liver Transplantation / adverse effects*
  • Postoperative Complications / diagnosis*
  • Postoperative Complications / etiology