Abstract
Background and aims Indirect peroral cholangiopancreatoscopy (IPOC) is a relatively new diagnostic and
therapeutic tool for biliopancreatic diseases. This international survey aimed to
evaluate clinical practice patterns in IPOC among endoscopists in Europe.
Methods An online survey was developed comprising 66 questions on the use of IPOC. Questions
were grouped into four domains. The survey was sent to 369 endoscopists who perform
IPOC.
Results 86 respondents (23.3 %) from 21 different countries across Europe completed the survey.
The main indications for cholangioscopy were determination of biliary strictures (85
[98.8 %]) and removal of common bile duct or intrahepatic duct stones (79 [91.9 %]),
accounting for an estimated use of 40 % (interquartile range [IQR] 25–50) and 40 %
(IQR 30–60), respectively, of all cases undergoing cholangioscopy. Pancreatoscopy
was mainly used for removal of pancreatic duct stones (68/76 [89.5 %]), accounting
for an estimated use of 76.5 % (IQR 50–95) of all cases undergoing pancreatoscopy.
Only 13/85 respondents (15.3 %) had an institutional standardized protocol for targeted
cholangioscopy-guided biopsy sampling. IPOC with lithotripsy was used as first-line
treatment in selected patients with bile duct stones or pancreatic stones by 24/79
(30.4 %) and 53/68 (77.9 %) respondents, respectively.
Conclusions This first European survey on the clinical practice of IPOC demonstrated wide variation
in experience, indications, and techniques. These results emphasize the need for prospective
studies and development of an international consensus guideline to standardize the
practice and quality of IPOC.
