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Once a rare undertaking, peroral cholangioscopy (POC) is now widely performed during endoscopic retrograde cholangiopancreatography (ERCP) to investigate biliary strictures, obtain tissue samples, and perform electrohydraulic and laser lithotripsy to fragment bile duct stones. With rare exceptions, all currently available cholangioscopes are so-called “daughter scopes,” which must first pass through the working channel of a duodenoscope before entering the bile duct.
Now, international investigators have conducted a prospective, randomized study to evaluate a prototype highly flexible, multibending (MB) ultra-slim endoscope that can be inserted directly into the bile duct without the need for a duodenoscope (i.e., freehand). A total of 92 pa…