{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:50:49Z","timestamp":1785261049520,"version":"3.55.0"},"reference-count":17,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,4,7]],"date-time":"2013-04-07T00:00:00Z","timestamp":1365292800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/3.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Although peroral direct cholangioscopy (<jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content>) is emerging as an alternative to traditional mother\u2010daughter cholangioscopy, it is associated with high failure rates. The aim of the present study was to evaluate the ability to insert and carry out interventions using a prototype multi\u2010bending <jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods<\/jats:title><jats:p>Prospective, observational clinical feasibility study was done in 41 patients with a variety of biliary diseases. A multi\u2010bending <jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content> prototype was inserted using a free\u2010hand technique, a guidewire alone, or with a 5\u2010<jats:styled-content style=\"fixed-case\">F<\/jats:styled-content>r diameter anchoring balloon. Diagnostic and therapeutic procedures were carried out.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The free\u2010hand direct insertion technique failed in all attempted cases (<jats:italic>n<\/jats:italic>\u2009=\u20097). Of the remaining 34 cases, successful rate of <jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content> insertion into the distal bile duct was achieved by passing the <jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content> over a guidewire alone (<jats:italic>n<\/jats:italic>\u2009=\u20096) and\/or with a guidewire plus anchoring balloon (<jats:italic>n<\/jats:italic>\u2009=\u200928) for an overall successrate of 88.2% (30\/34). In 13 (92.9%) patients without an underlying biliary stricture, <jats:styled-content style=\"fixed-case\">PDCS<\/jats:styled-content> insertion proximal to the bifurcation was possible. In 25 cases, biliary interventions were attempted including biopsy (<jats:italic>n<\/jats:italic>\u2009=\u200913), stone removal (<jats:italic>n<\/jats:italic>\u2009=\u20096), stent removal (<jats:italic>n<\/jats:italic>\u2009=\u20091), and intraductal electrohydraulic lithotripsy (<jats:italic>n<\/jats:italic>\u2009=\u20092) and were successful in 22 (88%). Other than two patients with procedure\u2010related cholangitis with a mild grade of severity, no complications were observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Using a novel multi\u2010bending prototype peroral direct cholangioscope, cholangioscopy had a high diagnostic and therapeutic success rate only when passed over a guidewire and anchoring balloon but not with the free\u2010hand insertion technique. Comparative studies of direct cholangioscopy are warranted.<\/jats:p><\/jats:sec>","DOI":"10.1111\/den.12082","type":"journal-article","created":{"date-parts":[[2013,4,8]],"date-time":"2013-04-08T01:36:44Z","timestamp":1365385004000},"page":"100-107","source":"Crossref","is-referenced-by-count":41,"title":["Clinical evaluation of a prototype multi\u2010bending peroral direct cholangioscope"],"prefix":"10.1111","volume":"26","author":[{"given":"Takao","family":"Itoi","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D Nageshwar","family":"Reddy","sequence":"additional","affiliation":[{"name":"Asian Institute of Gastroenterology  Hyderabad India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Sofuni","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical 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Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takayoshi","family":"Tsuchiya","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kentaro","family":"Ishii","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhito","family":"Ikeuchi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuminori","family":"Moriyasu","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Tokyo Medical University  Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jong 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