Intrahepatic biliary endoscopy in sclerosing cholangitis

Sclerosing cholangitis is usually diagnosed by clinical findings coupled with radiographic imaging of the bile ducts by ERCP. Direct imaging of both the intra- and extrahepatic biliary tree provides an opportunity to further study this disorder and its potential complications such as biliary malignancy. However, endoscopic visualization of the intrahepatic bile ducts in sclerosing cholangitis is potentially limited by the size of available cholangioscopes and the presence of strictures, Below, we report our initial results using a 0.8-mm fiberoptic endoscope placed through a partially steerable 1.8-mm guide catheter. The system allows visualization of the intrahepatic biliary tree beyond areas of stricture in the more distal ducts.