Ján Ušák, Rastislav Husťák, Jan Martínek
The development of per oral cholangioscopy is a logical developmental step in diagnostics and treatment of the biliary
tract disorders. The endoscopic retrograde cholangiopancreatography (ERCP) represented a revolutionary event
in the diagnostics and treatment of biliary tract. Its genius lies in the simplicity, safety and potential for solving most
diagnostic and therapeutic cases. The main deficiency is that it is an indirect examination. Practice has been long
awaiting an effective method of direct per oral cholangioscopy since some cases cannot be resolved by the ERCP
examination. Moreover, there is a need to deal with some situations through direct examination and targeted biopsy or
lithotripsy. This is a major deficiency of the ERCP, as it is limited by the indirect display of the biliary tract, stenoses and
concrements. The per oral cholangioscopy is not a new method, but it turns out that only single operator cholangioscopy
Spyglass®DS has allowed to standardise diagnostics and make it available to the wider professional community.