Per oral cholangiopancreatoscopy in pancreatico biliary diseases - Expert consensus statements

Mohan Ramchandani, Duvvur Nageshwar Reddy, Sundeep Lakhtakia, Manu Tandan, Amit Maydeo, Thoguluva Seshadri Chandrashekhar, Ajay Kumar, Randhir Sud, Rungsun Rerknimitr, Dadang Makmun, Christopher Khor

Research output: Contribution to journalReview articlepeer-review

29 Citations (Scopus)


AIM: To provide consensus statements on the use of per-oral cholangiopancreatoscopy (POCPS). METHODS: A workgroup of experts in endoscopic retrograde cholangiopancreatography (ERCP), endosonography, and POCPS generated consensus statements summarizing the utility of POCPS in pancreaticobiliary disease. Recommendation grades used validated evidence ratings of publications from an extensive literature review. RESULTS: Six consensus statements were generated: (1) POCPS is now an important additional tool during ERCP; (2) in patients with indeterminate biliary strictures, POCS and POCS-guided targeted biopsy are useful for establishing a definitive diagnosis; (3) POCS and POCS-guided lithotripsy are recommended for treatment of difficult common bile duct stones when standard techniques fail; (4) in patients with main duct intraductal papillary mucinous neoplasms (IPMN) POPS may be used to assess extent of tumor to assist surgical resection; (5) in difficult pancreatic ductal stones, POPS-guided lithotripsy may be useful in fragmentation and extraction of stones; and (6) additional indications for POCPS include selective guidewire placement, unexplained hemobilia, assessing intraductal biliary ablation therapy, and extracting migrated stents. CONCLUSION: POCPS is important in association with ERCP, particularly for diagnosis of indeterminate biliary strictures and for intra-ductal lithotripsy when other techniques failed, and may be useful for preoperative assessment of extent of main duct IPMN, for extraction of difficult pancreatic stones, and for unusual indications involving selective guidewire placement, assessing unexplained hemobilia or intraductal biliary ablation therapy, and extracting migrated stents.

Original languageEnglish
Pages (from-to)4722-4734
Number of pages13
JournalWorld Journal of Gastroenterology
Issue number15
Publication statusPublished - 21 Apr 2015


  • Cholangioscopy
  • Indeterninate biliary strictures
  • Intraductal lithotripsy
  • Pancreatoscopy
  • Per oral cholangiopancreatoscopy


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