The efficacy of 3D hologram support with mixed‐reality technique in pancreatobiliary endoscopy
Kazumasa Nagai, Maki Sugimoto, Takao Itoi, Hirohito Minami, Takayoshi Tsuchiya, Yoichi Araki, Ryosuke Tonozuka, Hiroyuki Kojima, Noriyuki Hirakawa, Shunichiro Orihara · Journal of Hepato-Biliary-Pancreatic Sciences · 2025
BACKGROUND AND AIMS: Mixed-reality (MR) technology is an advanced holographic imaging system that uses wearable devices to display three-dimensional (3D) images in clinical environments. In pancreatobiliary endoscopy, MR technology can facilitate 3D visualization of the bile and pancreatic ducts, enhancing spatial awareness and providing a more intuitive understanding of the anatomy. We evaluated the safety and efficacy of 3D hologram support (3D-HS) using MR in pancreatobiliary endoscopy. METHODS: This study included 30 patients who underwent pancreatobiliary endoscopy using 3D-HS between June 2023 and July 2024. The procedures included ERCP (n = 13) and interventional EUS (iEUS) (n = 17). The primary outcome was technical success, with secondary outcomes including total procedure-related time and adverse events. The conventional treatment group, matched for age and disease type, was compared to the 3D-HS group. a questionnaire was used to evaluate the MR device, 3D hologram images, and the overall evaluation with 3D-HS. RESULTS: The overall technical success rate was 96.7% (ERCP, 100%; iEUS, 93.8%). Adverse events occurred in 16.7% of cases; all were managed conservatively. comparison with conventional treatment showed no significant differences in outcomes, although conventional methods had shorter procedural times (p < 0.05). The questionnaire results indicated positive feedback on operability and image quality of 3D-HS, with enhanced anatomical understanding relative to 2D imaging, although some ERCP cases received lower ratings, particularly for intrahepatic bile duct stones. CONCLUSIONS: Pancreatobiliary endoscopy using 3D-HS can be safe and effective in enhancing anatomical understanding. Further studies are needed to optimize its use and reduce the total procedure time.