Petko Karagyozov

Acibadem City Clinic Tokuda Hopsital, Sofia, Bulgaria

ERCP has a history of more than 50 years and is an established gold standard for management of most biliary and pancreatic disorders. Despite its advancements many challenging and arduous situations still exist- difficult to remove stones, indeterminate biliary and pancreatic duct strictures, unclear filling defects etc. There is a need to improve diagnostic accuracy, tissue sampling technique and endoscopic therapeutic options. In many clinical scenarios the fluoroscopic image is not enough and we need to directly visualize the biliary and pancreatic ductal system. Cholangioscopy allows  visualization and the performance of therapeutic interventions under direct visual control. With the advancements in the endoscopic and imaging technology it has become an important modality for the diagnosis of indeterminate biliary and pancreatic lesions and useful endoscopic therapeutic tool in cases of difficult to remove ductal stones. Further improvements in the imaging and operability of the latest generation of cholangioscopy platforms have expanded the diagnostic and therapeutic capability and led to new clinical applications, including ductal tumor ablation, access to difficult to reach lesions in the biliary tree, transpapillary gallbladder drainage, foreign body extraction and many other.

In the presentation we are going to discuss the technical evolution of cholangioscopy and its current place in the algorithm for diagnosis and therapy of pancreato-biliary diseases.


KEYWORDS: cholangioscopy, SpyGlass, ERCP, difficult stones, indeterminate stricture, single-operator cholangiosciopy, laser lithotripsy


Petko Karagyozov, MD

Dr. Karagyozov received his medical degree from the Medical University of Sofia in 2004. Between 2005 and 2011 he completed his fellowship in gastroenterology and was a part of the team of  the Gastroenterology and Hepatology Clinic of Military Medical Academy - Sofia, under the guidance of Prof. Krum Katzarov and Prof. Dimitar Takov. In December 2012 Dr. Karagyozov acquired his specialty in Gastroenterology. In 2013 he completed fellowship in gastroenterology in Shonan Kamakura General Hospital, Kanagawa, Japan, as a part of a scientific exchange program among the hospitals in Tokushukai Medical Corporation. In 2014 he earned a scholarship from the European Society of Gastrointestinal Endoscopy (ESGE) and conducted a specialization in the Department of Interdisciplinary Endoscopy in Elisabethinen Hospital in Linz, Austria on the theme "Endoscopic ultrasound and endoscopic methods for treatment of chronic pancreatitis". Dr. Karagyozov competed also training programs in gastroenterology and therapeutic endoscopy in Germany, Czech Republic, The Netherlands, Italy, Israel and the USA.
Dr. Karagyozov is  member of the European Society of Gastrointestinal Endoscopy (ESGE), American Society for Gastrointestinal Endoscopy (ASGE), World Endoscopy Organization (WEO), Bulgarian Scientific Society for Gastroenterology. Since 2018 he is member of the Governing Board of the Bulgarian Scientific Society for Gastroenterology.

Dr. Karagyozov has more than 25 publications in international and Bulgarian scientific journals mostly in the field of therapeutic endoscopy and participated in more than 35 national and international gastroenterology meetings and congresses as a lecturer or poster presenter.
September 2011 he joined the Tokuda Hospital's team and since February 2015 he is head of Endoscopy Unit and head of Department of Interventional Gastroenterology at Acibadem City Clinic Tokuda Hospital, Sofia, Bulgaria. The department with 35 bets is recognized as one of the leading tertiary referral centers in Bulgaria, resolving difficult cases in gastroenterology and gastrointestinal endoscopy.

His main professional interests are in the field of therapeutic endoscopy, inflammatory bowel diseases and especially interventional diagnosis and treatment of pancreato-biliary disorders.

Since 2017 he is proctor for endoscopic cholangiopancreatoscopy with the SpyGlass DS System for Europe, Middle East and North Africa.

Since 2018 the Department of Interventional Gastroenterology at Acibadem City Clinic Tokuda Hopsital under his guidance is recognized as an international educational and training center for peroral cholangiopancreatoscopy.