A novel technique for peroral direct cholangioscopy.

Article Direct cholangioscopy has been possible since the 1970’s (1) but reliable intubation of the common bile duct (CBD) and second order ducts has limited the applicability of the technique. One of the limitations to accessing the ducts is the acute angulation between the duodenum and the CBD (2). Various methods have been employed to access the ducts including mother-and-baby endoscopes and balloon assisted intubation (3). Mother-and-baby systems are expensive, require additional equipment and provide poorer quality images than standard endoscopes. Balloon assisted intubation carries risk of damage to the CBD, requires specialist equipment with associated learning curve (4).