To explore the clinical application value of a novel domestic peroral cholangioscopy in the diagnosis of intraductal papillary neoplasms of the bile duct (IPNB).

A retrospective analysis was performed on the clinical data of 12 patients diagnosed with intraductal papillary neoplasm of the bile duct (IPNB) who underwent domestic peroral cholangioscopy between January 2020 and December 2025, including 11 patients from the Digestive Endoscopy Center of Jiangsu Provincial Hospital of Chinese Medicine and 1 patient from Nanjing Drum Tower Hospital..Abdominal imaging examinations (CT/MRI) revealed biliary duct dilation or space-occupying lesions in all patients. All patients further received ERCP combined with domestic peroral cholangioscopy.Endoscopic manifestations, biopsy pathological results and complications were recorded.

Among the 12 patients, there were 5 males and 7 females, aged 55 to 84 years old with an average age of (67.9±8.9) years.The main clinical manifestations included right upper abdominal pain (7 cases), right upper abdominal pain complicated with fever (4 cases), jaundice (1 case).Imaging examinations all indicated intrahepatic and/or extrahepatic bile duct dilation, among which filling defects or soft tissue shadows in the bile duct were observed in 6 cases. The morphological findings under peroral cholangioscopy were fish-egg-like lesions (4 cases), papillary lesions (5 cases) and waterweed-like lesions (2 cases), with mucus secretion identified in 8 patients.Lesions were located in hilar bile duct (5 cases), left hepatic duct (2 cases), right hepatic duct (1 case), hilar combined with left hepatic duct (1 case), upper segment and lower segment of common bile duct (1 case each), and the lesion site was unclear in 1 case.Endoscopic biopsy was performed in 10 patients.Pathological diagnoses included IPNB with carcinogenesis (2 cases), IPNB with high-grade intraepithelial neoplasia (2 cases), IPNB with low-grade intraepithelial neoplasia (3 cases), simple IPNB (1 case), chronic mucosal inflammation (2 cases), and no biopsy was conducted in 2 cases.No severe complications occurred after cholangioscopy.Two patients developed hyperamylasemia and one patient suffered from biliary tract infection, all of whom recovered within 48 hours.

Domestic peroral cholangioscopy can directly observe the morphological characteristics of intraductal biliary lesions, and can achieve accurate diagnosis of IPNB combined with biopsy pathology. It features favorable safety and possesses important clinical application value.