{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:54Z","timestamp":1790690874569,"version":"4.1.0"},"reference-count":20,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Digestive Endoscopy"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Peroral cholangiopancreatoscopy (POCPS) is established for diagnosis and treatment of pancreatobiliary diseases in patients with normal anatomy, but has been difficult to perform in patients with surgically altered anatomy (SAA) because conventional cholangioscope systems cannot pass through the working channel of balloon endoscopes. The novel 9Fr cholangioscope (eyeMAX 9Fr; Micro\u2010Tech) has a 3.2\u2010mm outer diameter, enabling passage through the 3.2\u2010mm working channel of short\u2010type balloon endoscopes and allowing through\u2010the\u2010channel POCPS during balloon endoscopy\u2010assisted ERCP (BE\u2010ERCP) without scope exchange. We retrospectively evaluated 38 consecutive BE\u2010POCPS procedures using the eyeMAX 9Fr in patients with SAA at two tertiary centers in Japan. Indications included biliary stone (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200931), pancreatobiliary stricture (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094), pancreatic stone (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091), cystic duct selection (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091), and migrated stent retrieval (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091). Technical success was achieved in all 38 cases (100%) across five reconstruction types using both single\u2010balloon and double\u2010balloon endoscopes. For lithotripsy (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u200932), stone fragmentation was successful in all cases, with single\u2010session complete stone clearance in 53.1%. For stricture evaluation (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20094), visual assessment\u2013final diagnosis concordance was 75.0% (3\/4) and biopsy adequacy rate was 75% (3\/4); biopsy\u2013final diagnosis concordance was 100% among adequate specimens (3\/3). Adverse events occurred in three cases (7.9%), including lithotripsy\u2010related bile duct mucosal injury\/bleeding (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20092), and scope\u2010related small bowel perforation (\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u20091). BE\u2010POCPS using the eyeMAX 9Fr is a feasible and safe approach enabling direct visualization, targeted biopsy, and lithotripsy in SAA patients without scope exchange.\n                  <\/jats:p>","DOI":"10.1111\/den.70237","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:52:10Z","timestamp":1784044330000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Efficacy and Safety of Balloon Endoscopy\u2010Assisted Peroral Cholangiopancreatoscopy (\n                    <scp>POCPS<\/scp>\n                    ) Using a Novel 9Fr Cholangioscope in Patients With Surgically Altered Anatomy: A Dual\u2010Center Retrospective Study (With Video)"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7300-3665","authenticated-orcid":false,"given":"Haruka","family":"Toyonaga","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuki","family":"Tanisaka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Makoto","family":"Masaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arata","family":"Oka","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akihiro","family":"Okita","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumiya","family":"Osaki","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Matsuno","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"},{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shoji","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Nakata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuya","family":"Takayama","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Orino","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironao","family":"Matsumoto","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Hepatology Kansai Medical University Medical Center  Osaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryosuke","family":"Hamamura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryuichi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suguru","family":"Ito","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Saitama Medical University International Medical Center  Hidaka 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