Peroral Cholangioscopy: How Technology and Imaging Have Changed ERCP

J Laparoendosc Adv Surg Tech A. 2020 Sep;30(9):973-979. doi: 10.1089/lap.2020.0458. Epub 2020 Jul 30.


Endoscopic retrograde cholangiopancreatography (ERCP) is the minimally invasive standard of care for the treatment of several biliary and pancreatic pathologies. One of the limitations of this technique is the lack of endoluminal vision within the biliary tree or Wirsung's duct. This limits the diagnostic accuracy of the procedure and reduces the effectiveness of many treatments. Technological progress and the use of increasingly ergonomic and high-definition imaging equipment have led to the dissemination of peroral cholangioscopy (POC). Thanks to the high quality of video image resolution, POC could well be a powerful tool used to characterize malignant biliary strictures. It could also allow targeted biopsies or local treatments, hence reducing the risk of complications and increasing outcomes. The technological improvement of the last generation of POC is opening new horizons in the treatment of biliopancreatic pathologies, thereby contributing to refine and enhance the ERCP management of several diseases in the near future.

Keywords: ERCP; biliary tract; cholangioscopy.

MeSH terms

  • Biliary Tract Diseases / diagnostic imaging*
  • Biliary Tract Diseases / surgery
  • Cholangiopancreatography, Endoscopic Retrograde
  • Endoscopy, Digestive System / methods*
  • Humans
  • Pancreatic Diseases / diagnosis*
  • Pancreatic Diseases / surgery
  • Technology