Department of Gastroenterology and Hepatology, Cleveland Clinic Florida, Weston, FL, USA.
Curr Opin Gastroenterol. 2013 Sep;29(5):501-8. doi: 10.1097/MOG.0b013e3283640f4b.
Endoscopists have long awaited advances in the equipment and techniques for cholangiopancreatoscopy. Since the turn of the millennium, endoscopists have witnessed an explosion in the development and refinement of the capabilities of cholangioscopes as they move from being almost exclusive to tertiary care academic settings to a wider range of practices.
Studies have tested and constructively critiqued the procedure, hoping to increase the success rate of diagnostic and therapeutic interventions. Many have found significant improvement upon the limitations of radiographic imaging in diagnosing diseases and achieving full clearance of biliary stones. Image quality has improved with a range of features. However, most of these still need to be studied further. The addition of balloon catheters and overtubes has improved stability and access to the biliary ducts, but comes with complications that need to be studied further.
Although we still have improvements to yearn for, the future looks bright. As endoscopists continue their commitment to the promise of direct visualization of the biliary trees and the complementary tools for diagnosis and treatment, we are continuing to raise quality of care for patients with complicated biliary diseases.
长久以来,内镜医生一直期待胆管胰管镜设备和技术的进步。自千禧年以来,胆管镜的发展和功能的完善呈爆炸式增长,它们已经从仅限于三级医疗学术环境扩展到更广泛的应用范围。
研究人员对该程序进行了测试和建设性的批评,希望提高诊断和治疗干预的成功率。许多人发现,与放射成像相比,在诊断疾病和清除胆管结石方面有了显著的改善。图像质量也因各种特性而得到改善。然而,其中的大多数仍需要进一步研究。球囊导管和外套管的增加提高了胆管的稳定性和可及性,但也带来了需要进一步研究的并发症。
尽管我们仍有改进的空间,但未来前景光明。随着内镜医生继续致力于直接可视化胆道树的承诺,以及诊断和治疗的补充工具,我们将继续提高复杂胆道疾病患者的护理质量。