St. Bogardus et al., MOTHER-BABY BILIARY ENDOSCOPY - THE UNIVERSITY-OF-CHICAGO EXPERIENCE, The American journal of gastroenterology, 91(1), 1996, pp. 105-110
Objectives: The ''mother-baby'' technique of peroral cholangioscopy is
a relatively recent development in biliary endoscopy and permits dire
ct visualization of the biliary tree, This paper presents the experien
ce of one institution with this new technique. Methods: We used the Ol
ympus mother-baby endoscopy system at the University of Chicago and at
one of its affiliated hospitals to examine and treat selected lesions
in the biliary tree that had eluded successful diagnosis or treatment
by standard means, In addition, we used the baby endoscope alone thro
ugh surgically created percutaneous tracts to treat selected patients
with retained stones. Results: From July 1990 to June 1993, peroral ch
olangioscopy was performed 18 times in 12 patients at the University o
f Chicago and affiliated hospitals, The baby endoscope was successfull
y passed into the bile duct in 15 of 18 cases (83.3%), Additionally, t
he baby endoscope alone was used through a T-tube or cholecystostomy t
ract 10 times in six patients, Complications occurred in two patients
and were minor; there were no fatalities, With refinement of technique
, successful passage of the baby endoscope was accomplished in 100% of
patients undergoing peroral cholangioscopy. Conclusions: Direct visua
lization of the biliary tree with the ability to sample (brush, biopsy
) or treat (basket removal, electrohydraulic or laser lithotripsy) les
ions significantly aided in the care of all patients in whom the baby
endoscope was successfully passed by providing the correct diagnosis a
nd, when appropriate, by allowing definitive treatment of lesions, The
eventual role of this technique in the current cost-conscious climate
is unclear, but at present it should be limited to selected referral
centers.