Potential Role of Peroral Cholangioscopy for Preoperative Diagnosis of Cholangiocarcinoma

Background/Purpose: We evaluated the utility of peroral cholangioscopy (POCS) for preoperative diagnosis of cholangiocarcinoma. Methods: POCS was performed to assess the horizontal extension of the carcinoma. We compared the results of assessment with those of histologic analysis of 44 surgically resected specimens. Results: Cholangiocarcinoma types were described as filling defects and strictures in 16 and 28 patients, respectively, using cholangiography. Endoscopic retrograde cholangiography (ERC) identified tumor extension in 5 and 15 patients with filling defects (31.25%) and strictures (53.57%), respectively. ERC + POCS identified tumor extension in 15 and 16 patients with filling defects (93.75%) and strictures (60.71%), respectively. ERC + POCS was significantly useful for patients with filling defects compared with ERC alone (P = 0.002). ERC + POCS was not significantly useful for patients with strictures compared with ERC alone. Conclusions: POCS is a useful preoperative examination modality for assessing tumor extension in cholangiocarcinoma patients, especially in those with filling defects.