Successful cholangioscopy-guided biopsy using a novel thin cholangioscope under balloon enteroscopy in a patient with Roux-en-Y gastrectomy

Peroral cholangioscopy (POCS) is beneficial not only for direct visualization of intraductal bile duct lesions but also for biopsy under direct cholangioscopic view [1] [2]. However, the concept of POCS and cholangioscopy-guided biopsy by means of balloon enteroscopy is problematic. This is because cholangioscopes are approximately 10 Fr in diameter and cannot pass through the forceps channel of the balloon enteroscope. We report a successful cholangioscopy-guided biopsy using a novel thin cholangioscope with balloon enteroscopy in a patient with Roux-en-Y gastrectomy.S