Ishida Yusuke, Itoi Takao, Okabe Yoshinobu
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Fukuoka, Japan.
Department of Gastroenterology and Hepatology, Tokyo Medical University, Japan.
Best Pract Res Clin Gastroenterol. 2015 Aug;29(4):611-25. doi: 10.1016/j.bpg.2015.05.007. Epub 2015 Jun 9.
A new video peroral cholangioscopy (POCS) has been developed with high-quality digital imaging, and its clinical use has been reported. Additionally, direct peroral cholangioscopy (D-POCS) using an ultraslim endoscope has been proposed recently. To improve the diagnostic yield of POCS or D-POCS, image-enhanced endoscopy has been used in combination. Chromoendoscopy with methylene blue staining (ME), autofluorescence imaging (AFI), and narrow-band imaging (NBI) has been evaluated in biliary tract diseases. Observation of the mucosal structure and vessels is reportedly important for distinguishing non-neoplasms from neoplasms. Therefore, NBI is the most promising tool among image-enhanced endoscopies as it can enhance visualization of the mucosal structure and vessels simultaneously. There are currently few reports that have evaluated the utility of POCS or D-POCS based on pathological findings. Thus, endoscopic findings of the bile duct mucosa have not yet been fully established. At present, POCS-guided biopsy should be carried out.
一种具有高质量数字成像功能的新型经口胆管镜检查（POCS）已被研发出来，并且其临床应用已有报道。此外，最近有人提出使用超薄内窥镜进行直接经口胆管镜检查（D-POCS）。为了提高POCS或D-POCS的诊断率，已联合使用了图像增强内镜检查。已对胆管疾病中的亚甲蓝染色（ME）、自体荧光成像（AFI）和窄带成像（NBI）等染色内镜检查进行了评估。据报道，观察黏膜结构和血管对于区分非肿瘤性病变和肿瘤性病变很重要。因此，NBI是图像增强内镜检查中最有前景的工具，因为它可以同时增强黏膜结构和血管的可视化。目前很少有基于病理结果评估POCS或D-POCS效用的报告。因此，胆管黏膜的内镜检查结果尚未完全确立。目前，应进行POCS引导下的活检。
