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Background & Aims: We evaluated the diagnostic ability of a newly developed peroral video cholangioscopy (PVCS) in patients with pancreaticobiliary disorders. Methods: We retrospectively evaluated data from 144 patients with pancreaticobiliary disorders, collected from 5 tertiary referral centers. Endoscopic sphincterotomy (EST) or endoscopic papillary balloon dilation (EPBD) was performed before PVCS. We performed 2 types of PVCS, using a conventional therapeutic duodenoscope. If tissue samples were needed, cholangioscopy-assisted biopsy or fluoroscopy-guided biopsy was performed. Results: PVCS was advanced into the bile duct in all cases after patients received EST (n = 134 cases), EPBD (n = 2), a combination of EST and EPBD (n = 1), or without treatment of the major papilla (n = 7). Biopsy samples were collected successfully from 112 of 120 cases in which endoscopists considered tissue sampling necessary. Endoscopic retrograde cholangiopancreatography (ERCP)/biopsy correctly identified 83 of 96 malignant lesions and 19 of 24 benign lesions (accuracy = 85.0%; sensitivity = 86.5%; specificity = 79.2%; positive predictive value = 94.3%; negative predictive value = 59.4%). Endoscopic retrograde cholangiopancreatography (ERCP)/biopsy plus PVCS correctly identified 95 of 96 malignant lesions and 23 of 24 benign lesions (accuracy = 98.3%; sensitivity = 99.0%; specificity = 95.8%; positive predictive value = 99.0%; negative predictive value = 95.8%). Procedure-related complications included pancreatitis (4 cases, 2.8%) and cholangitis (6 cases, 4.3%). Conclusions: PVCS is an accurate diagnostic tool for patients with pancreaticobiliary disorders; resolution was well-defined when combined with biopsy analysis. Prospective multicenter clinical trials should evaluate the clinical utility of PVCS in diagnosis of biliary tract diseases. [ABSTRACT FROM AUTHOR]

Background: Double-balloon enteroscopy (DBE) is a useful and epoch-making technique for small-bowel diseases. The single-balloon enteroscope (SBE) is a new instrument introduced by Olympus. Objective: To evaluate a prototype of the SBE. Design: A prospective case series. Setting: Kyoto Second Red Cross Hospital, between April 2006 and July 2007. Patients: We used the SBE system to perform 37 enteroscopic examinations on 27 patients, including 22 oral and 15 anal approaches. Main Outcome Measurements: The rate of whole small-bowel visualization, mean time necessary for the investigation, discovery rate of lesions, and complications. Results: We observed the entire small intestine in 1 of 8 cases (12.5%) that we examined. The mean (±SD) time necessary for the oral approach was 83 ± 38 minutes and that for the anal approach was 90 ± 32 minutes. The preparation time was less than 5 minutes in both approaches. Small-intestinal lesions were detected in 11 of the 27 patients (40.7%). Perforation occurred in one case as a complication, but the injury healed without surgical intervention. Limitation: This was a single-center study. Conclusions: Use of the SBE system in the endoscopic study of the small intestine makes it possible to observe the entire small intestine and to diagnose lesions; thus, the SBE system is a useful instrument for small-bowel diseases. However, the rate of whole small-bowel visualization was inferior to the DBE system. [Copyright &y& Elsevier]