Feasibility of Novel Slim Peroral Cholangiopancreatoscopy for the Diagnosis of Pancreatobiliary Disease

Objectives

To evaluate the clinical outcomes of peroral cholangiopancreatoscopy (POCPS) using the 9-Fr eyeMAX for the diagnosis of pancreatobiliary diseases.

Methods

This retrospective study enrolled 43 patients who underwent POCPS using the 9-Fr eyeMAX for diagnostic procedures at two tertiary referral centers between May 2023 and November 2024. The primary outcome was the incidence of adverse events following POCPS. Patient backgrounds, procedural details, technical success (successful insertion of the 9-Fr eyeMAX), and adequate tissue sampling were also analyzed.

Results

Of the 43 patients, 32 were male, and 11 were female, with a median age of 75 years (range, 46–87 years). Peroral cholangioscopy (POCS) was performed on 30 patients. The final diagnosis in this cohort was an ampullary tumor (n = 2), extrahepatic bile duct cancer (n = 16), gallbladder cancer (n = 3), metastatic liver tumor (n = 1), and benign biliary stricture (n = 8). The adequate tissue sampling rate for the POCS was 86.4%. Adverse events after POCS occurred in two patients (6.7%), including mild pancreatitis (n = 1) and fever (n = 1). Peroral pancreatoscopy (POPS) was performed on 13 patients. The final diagnoses of all patients undergoing POPS were intraductal papillary mucinous neoplasms (IPMN), categorized as branch duct-type IPMN (n = 1), mixed-type IPMN (n = 8), and main duct-type IPMN (n = 4). The technical success rate was 92.3% (12/13). The tissue sampling rate for POPS was 83.6%. No adverse events, such as pancreatitis, were observed.

Conclusions

The 9-Fr eyeMAX facilitates a safe POCPS procedure, achieving a high technical success rate and an adequate tissue sampling rate.