ASGE International Sampler (On-Demand)-ERCP - Indeterminate Biliary Stricture

ERCP - Indeterminate Biliary Stricture - Role of peroral cholangioscopy (POCS)

Video Transcription

Video Summary

In the video, Professor Horst Neuhaus, a world-renowned expert in diagnostic and therapeutic endoscopy, discusses the role of pro-oral cholangioscopy in evaluating indeterminate biliary strictures. He suggests an algorithm for the diagnosis and treatment of these strictures. Initially, non-invasive procedures such as MRCP and EUS should be used to evaluate the location and determine if further differentiation is necessary. If surgery is already planned or if the patient is not a candidate for chemotherapy or surgery, ESCP stenting can be considered. However, if further differentiation is required, tissue acquisition is necessary, and the use of cholangioscopy is recommended for its accuracy. Professor Neuhaus explains the different techniques of cholangioscopy, including direct paroral cholangioscopy and single operator cholangioscopy, and provides case examples to demonstrate their application and benefits. He also discusses the results of studies that show the superiority of single operator cholangioscopy in terms of sensitivity for diagnosis. Furthermore, he emphasizes the importance of interdisciplinary discussions and the economic impact of using cholangioscopy for indeterminate biliary lesions. Overall, cholangioscopy provides a more accurate and targeted approach for evaluating and treating these strictures.

Asset Subtitle

Horst Neuhaus, MD

Keywords

pro-oral cholangioscopy

indeterminate biliary strictures

diagnosis and treatment

cholangioscopy techniques

single operator cholangioscopy

interdisciplinary discussions