Intraductal Endoscopy: Cholangioscopy lets doctors see what x-rays can't

By Nick Rees

A cholangioscopy, also known as an intraductal endoscopy, allows a doctor to examine the bile ducts by using what is known as a fiberoptic endoscope, which consists of a tube, a light to illuminate inside the body and a lens to transmit images.  The advantages of this procedure is that it allows for higher rates of success in removal of stones, higher success of diagnosis  can be accomplished through a combination of visual inspection and endoscopic-guided biopsy and higher accuracy of endoscopic biopsy for intraluminal masses.

Dr. Willis Parsons of Northwest Community Hospital, a top rated gastroenterologist in Chicago, is an expert at performing cholangioscopies.

"Cholangioscopy is a procedure I have been performing for many years now," Dr. Parsons said. "This allows us to place a small endoscope into the bile duct, allowing direct visualization and tissue sampling and/or pulverizing gallstones that have fallen into the duct causing a blockage."

During a cholangioscopy, a small tube known as a duodenoscope is inserted into a patient's mouth and down the esophagus into the stomach and duodenum. There, it reaches the biliary tree, which is responsible for draining the gallbladder, liver and pancreas into the duodenum, which is the first part of the small intestine.  Once the duodenoscope is in place, a thin, fiber optic scope is then inserted into the duodenoscope to the portion of the duct to give the doctor direct visualization within the body.

While the duodenoscope is in place, if the doctor wants to investigate further, then other procedures can be performed including tissue sampling or the removal of stones and other debris.

"Performing advanced endoscopic procedures is akin to being a car mechanic but having to get to the engine through the tailpipe," Dr. Parsons said. "Basically, I am performing surgery using the endoscope, not the scalpel."

Recovery times from a cholangioscopy, which is performed either under conscious sedation, MAC or general anesthesia, vary depending on what disease is being treated. Cholangioscopies can be performed as either inpatient or outpatients procedures in a hospital.

Dr. Willis Parsons of Northwest Community Hospital in Arlington Heights, IL was selected in 2010 by TopTierMD as a Chicago Top Doctor - He was named a Best Chicago Gastroenterologist specializing in advanced therapeutic procedures involving the bile duct and pancreas, including ERCP and endoscopic ultrasound with fine needle aspiration, ablation of Barrett's esophagus, capsule endoscopy, colonoscopies and endoscopic procedures. Dr. Parsons leads the Center for Advanced Therapeutic Endoscopy in Arlington Heights, IL at Northwest Community Hospital.