Per-oral fine-caliber cholangio-pancreaticoscopy (development for ordinary clinical application)

Abstract

We have developed a new type of fine fiberscope (2.2 mm in external diameter) for peroral transpapillary observation of the bile duct or the pancreatic duct without papillotomy. This scope consists of a image glass fiber with 3000 pixels, seven light-guide plastic fibers and one working channel of 1.0 mm in diameter. The scope can be inserted into the bile duct or the pancreatic duct through the channel of the conventional duodenoscope. Another devices of this kind of fine scope, which have already been offered for clinical use, are very fragile. The fragility makes it difficult to use it for clinical practice. When we planned to revise this fine scope, we paid our attention mainly to reduce fragility. Exchanging the light guide glass fibers for plastic fibers was the most important progress on that point. Insertion of the scope into the bile duct or the pancreatic duct through the conventional duodenoscope requires no special techniques. Another amelioration concerned to the shape of the tip and location of the working channel of this scope must be brought out in order to perform easy insertion into the bile and pancreatic duct through normal papilla, because the success rate of insertion of the present scope is not high (60%). Direct inspection by the fine scope will improve the diagnostic reliability for lesions of the bile duct and the pancreatic duct. © 1993, Japan Gastroenterological Endoscopy Society. All rights reserved.