The SpyGlass DS system is currently used as a direct video cholangioscope for biliary diagnostic and therapeutic procedures. In general, the SpyGlass DS cholangioscope is passed through the working channel of a duodenoscope and inserted into a bile duct via duodenal papilla. However, the procedure has been challenging in patients with altered gastrointestinal anatomy due to the retrograde route through a potentially tortuous afferent limb. A therapeutic colonoscope with variable stiffness can offer alternative guidance for SpyGlass DS cholangioscope in patients with surgically altered gastrointestinal anatomy.
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