duodenoskopian

Duodenoskopian, or duodenoscope, is a specialized endoscope designed for examination of the duodenum and, most commonly, for performing endoscopic retrograde cholangiopancreatography (ERCP). The instrument is a long, flexible tube equipped with a side-viewing lens at the distal tip, a bidirectional bending section, illumination, and one or more working channels. The main working channel is used to introduce instruments and contrast media; many duodenoscopes also feature a second smaller channel for guidewires and accessories. A built-in elevator at the tip helps align accessories with the major papilla for selective cannulation of the bile and pancreatic ducts.

In clinical use, the duodenoscope is inserted through the mouth and navigated through the esophagus and stomach into the second part of the duodenum. The procedure allows diagnostic evaluation of the duodenum and, more importantly, therapeutic maneuvers such as sphincterotomy, stone extraction, stent placement, balloon dilation, biopsy, and ductal cannulation under fluoroscopic guidance.

Common indications include obstructive jaundice, cholangitis, suspected biliary or pancreatic ductal disease, and evaluation of duodenal lesions. Potential complications include pancreatitis, perforation, bleeding, infection, and adverse reactions to sedation. Proper sterilization and reprocessing are essential, given the risk of device-associated infections; increasingly, disposable components and strict regulatory guidelines are used to mitigate this risk.

The duodenoscope was developed to enable access to the biliary and pancreatic ducts and to permit therapeutic interventions during ERCP, a technique introduced in the mid-20th century.