Direct pancreatoscopy.

Direct pancreatoscopy has inherent limitations, which include lack of instrument availability, scope fragility, small image size, lack of traditional endoscope features, and need for two endoscopists. Despite the above, centers with large pancreaticobiliary referral practice will selectively use this technology both diagnostically and therapeutically. The variability of pancreatic duct angulation and diameter, the presence of variably obstructing stenoses or filling defects, and the need to concomitantly apply this technology to the biliary tree all suggest that a family of miniscopes will be required as opposed to a single "ideal" instrument.