Cholangioscopy (Spyglass)

What is a Cholangioscopy?

Cholangioscopy is a special, miniature, flexible lighted tube that is used to visualize the bile ducts (tubes carrying bile from the liver into the small intestine) and sometimes the main pancreatic duct (tube carrying enzymes and other juices from the pancreas). This instrument is used during an endoscopic retrograde cholangiopancreatography (ERCP), which is one of the main endoscopic procedures used to investigate and treat disorders of bile ducts and pancreas.

Why is a Colongioscopy Done?

There are a few reasons for deploying Cholangioscopy during an ERCP:

• To remove larger, more difficult stones in the bile duct or sometimes the main pancreatic duct that could not be extracted safely during standard ERCP. Direct visualization with the cholangioscope permits the doctor to use tools with either laser or electrohydraulic therapy to break up the stone.
• Directly visualize and biopsy growths, tumors, and strictures (narrowed segments) in the bile duct.
• Visualize and biopsy growths, tumors in the main pancreatic duct. This is only permissible when the pancreatic duct is enlarged (dilated).

What are the Risks Associated With Cholangioscopy?

Generally, Cholangioscopy along with ERCP is a well-tolerated procedure when performed by physicians who have the proper skills and training. The risks of complications are low, but they can occur. One complication is pancreatitis, which is inflammation of the pancreas. Other complications can include internal bleeding from the intestines, bile or pancreatic ducts, infection, or perforation (a hole or a deep tear in the lining of the gastrointestinal tract). Other risks involve complications related to the anesthetics and sedatives (breathing difficulties, aspiration) or complications related to heart and lung disease.