Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video)

Toru Ueki, Motowo Mizuno, Shigeru Ota, Tsuneyoshi Ogawa, Hiroshi Matsushita, Daisuke Uchida, Norifumi Numata, Asuka Ueda, Yuuki Morimoto, Yoko Kominami, Shintaro Nanba, Manabu Kurome, Hirotoki Ohe, Masahiro Nakagawa, Yasuyuki Araki

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Background: Peroral cholangioscopy (POCS) is useful for the diagnosis of various bile duct lesions. However, it is often difficult to obtain clear images because of bile or biliary sludge in the bile duct, even after vigorous irrigation of the bile duct with saline solution. Therefore, this study investigated whether inflation with carbon dioxide (CO2) yields clearer images of the bile duct than conventional saline solution irrigation during POCS. Objective: To evaluate the clinical utility and safety of CO2 insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation. Setting: A single center. Design: Case-control study. Patients: Nineteen patients with suspected biliary diseases. Interventions: CO2 insufflation into the bile duct during POCS. Main Outcome Measurements: The quality and safety of this method. Result: The quality of the images of the bile duct lumen with CO2 insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P < .05) and color (P < .05). In particular, extremely clear images could be obtained from the middle part of common bile duct to the right and left hepatic duct. No serious POCS-related complications occurred. There was no significant change in the venous partial pressure of the CO2 level during the procedure. Limitations: The number of patients examined was small. Conclusions: CO2 insufflation is useful for obtaining clear images of the bile duct during POCS, which makes it possible to determine the qualitative diagnosis and the extent of various bile duct lesions.

Original languageEnglish
Pages (from-to)1046-1051
Number of pages6
JournalGastrointestinal Endoscopy
Volume71
Issue number6
DOIs
Publication statusPublished - May 1 2010
Externally publishedYes

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Insufflation
Bile Ducts
Carbon Dioxide
Sodium Chloride
Bile
Safety
Common Hepatic Duct
Venous Pressure
Partial Pressure
Economic Inflation
Common Bile Duct
Case-Control Studies
Color

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

Cite this

Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video). / Ueki, Toru; Mizuno, Motowo; Ota, Shigeru; Ogawa, Tsuneyoshi; Matsushita, Hiroshi; Uchida, Daisuke; Numata, Norifumi; Ueda, Asuka; Morimoto, Yuuki; Kominami, Yoko; Nanba, Shintaro; Kurome, Manabu; Ohe, Hirotoki; Nakagawa, Masahiro; Araki, Yasuyuki.

In: Gastrointestinal Endoscopy, Vol. 71, No. 6, 01.05.2010, p. 1046-1051.

Research output: Contribution to journalArticle

Ueki, T, Mizuno, M, Ota, S, Ogawa, T, Matsushita, H, Uchida, D, Numata, N, Ueda, A, Morimoto, Y, Kominami, Y, Nanba, S, Kurome, M, Ohe, H, Nakagawa, M & Araki, Y 2010, 'Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video)', Gastrointestinal Endoscopy, vol. 71, no. 6, pp. 1046-1051. https://doi.org/10.1016/j.gie.2010.01.015
Ueki, Toru ; Mizuno, Motowo ; Ota, Shigeru ; Ogawa, Tsuneyoshi ; Matsushita, Hiroshi ; Uchida, Daisuke ; Numata, Norifumi ; Ueda, Asuka ; Morimoto, Yuuki ; Kominami, Yoko ; Nanba, Shintaro ; Kurome, Manabu ; Ohe, Hirotoki ; Nakagawa, Masahiro ; Araki, Yasuyuki. / Carbon dioxide insufflation is useful for obtaining clear images of the bile duct during peroral cholangioscopy (with video). In: Gastrointestinal Endoscopy. 2010 ; Vol. 71, No. 6. pp. 1046-1051.
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AU - Ueki, Toru

AU - Mizuno, Motowo

AU - Ota, Shigeru

AU - Ogawa, Tsuneyoshi

AU - Matsushita, Hiroshi

AU - Uchida, Daisuke

AU - Numata, Norifumi

AU - Ueda, Asuka

AU - Morimoto, Yuuki

AU - Kominami, Yoko

AU - Nanba, Shintaro

AU - Kurome, Manabu

AU - Ohe, Hirotoki

AU - Nakagawa, Masahiro

AU - Araki, Yasuyuki

PY - 2010/5/1

Y1 - 2010/5/1

N2 - Background: Peroral cholangioscopy (POCS) is useful for the diagnosis of various bile duct lesions. However, it is often difficult to obtain clear images because of bile or biliary sludge in the bile duct, even after vigorous irrigation of the bile duct with saline solution. Therefore, this study investigated whether inflation with carbon dioxide (CO2) yields clearer images of the bile duct than conventional saline solution irrigation during POCS. Objective: To evaluate the clinical utility and safety of CO2 insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation. Setting: A single center. Design: Case-control study. Patients: Nineteen patients with suspected biliary diseases. Interventions: CO2 insufflation into the bile duct during POCS. Main Outcome Measurements: The quality and safety of this method. Result: The quality of the images of the bile duct lumen with CO2 insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P < .05) and color (P < .05). In particular, extremely clear images could be obtained from the middle part of common bile duct to the right and left hepatic duct. No serious POCS-related complications occurred. There was no significant change in the venous partial pressure of the CO2 level during the procedure. Limitations: The number of patients examined was small. Conclusions: CO2 insufflation is useful for obtaining clear images of the bile duct during POCS, which makes it possible to determine the qualitative diagnosis and the extent of various bile duct lesions.

AB - Background: Peroral cholangioscopy (POCS) is useful for the diagnosis of various bile duct lesions. However, it is often difficult to obtain clear images because of bile or biliary sludge in the bile duct, even after vigorous irrigation of the bile duct with saline solution. Therefore, this study investigated whether inflation with carbon dioxide (CO2) yields clearer images of the bile duct than conventional saline solution irrigation during POCS. Objective: To evaluate the clinical utility and safety of CO2 insufflation into the bile duct to obtain clear images in POCS observations by comparing this method with conventional saline solution irrigation. Setting: A single center. Design: Case-control study. Patients: Nineteen patients with suspected biliary diseases. Interventions: CO2 insufflation into the bile duct during POCS. Main Outcome Measurements: The quality and safety of this method. Result: The quality of the images of the bile duct lumen with CO2 insufflation (10 patients) was significantly superior to those with saline solution irrigation (9 patients) in both clarity (P < .05) and color (P < .05). In particular, extremely clear images could be obtained from the middle part of common bile duct to the right and left hepatic duct. No serious POCS-related complications occurred. There was no significant change in the venous partial pressure of the CO2 level during the procedure. Limitations: The number of patients examined was small. Conclusions: CO2 insufflation is useful for obtaining clear images of the bile duct during POCS, which makes it possible to determine the qualitative diagnosis and the extent of various bile duct lesions.

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