Endoscopy 2020; 52(07): 617-618
DOI: 10.1055/a-1166-2575
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Commentary

Klaus Mönkemüller
1   Department of Internal Medicine, Ameos Clinic, Teaching Hospital of the Otto-von-Guericke University Magdeburg, Halberstadt, Germany
2   University of Belgrade, Belgrade, Serbia
› Author Affiliations
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Obtaining tissue from the biliary tract using standard biopsy forceps may be cumbersome. The authors present a tunneling technique, wherein a dilating catheter is first inserted first into the bile duct, and then the forceps is pushed through the “tunnel” catheter into the bile duct. This technique enables easy access by forceps into the biliary tract, as compared with the free biopsy cannulation technique, which is quite difficult as the forceps tip is stiff and has a 70 – to 90-degree angle from the duodenoscope.

In our own practice we use a stent-pushing catheter as the means of access (the “mini-overtube” bile duct access technique), to obtain tissue from the bile ducts, and to perform therapeutic interventions such as: (a) extraction of proximally migrated stents; (b) manipulation of multiple wires; (c) direct cholangioscopy using fiberoptic cable; (d) photodynamic therapy; and (e) passage through complex biliary strictures [1] [2] [3].



Publication History

Article published online:
24 June 2020

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