Cholangioscopy and pancreatoscopy

Cholangiopancreatoscopy has evolved significantly since its introduction over 40 years ago. The systems have gone through multiple iterations that has allowed for widespread performance of per-oral cholangiopancreatoscopy for diagnostic and therapeutic intent. Development of imaging criteria is evolving and its yield in the detection of neoplasia in conjunction with targeted tissue sampling is excellent. However, image interpretation remains a challenge. Guidelines for training in per-oral cholangiopancreatoscopy, as well as demonstration of competency, are currently lacking but require deliberate debate as the technology continues to gather enthusiasm and momentum as an established complement to endoscopic retrograde cholangiopancreatography.