Biliary strictures arise from diverse benign and malignant etiologies, and accurate differentiation is pivotal for prognosis and treatment selection. Conventional endoscopic retrograde cholangiopancreatography (ERCP)-based sampling (brush cytology and forceps biopsy) suffers from limited sensitivity despite high specificity, leaving a substantial proportion as indeterminate biliary strictures. Peroral cholangioscopy (POCS) enables direct intraductal visualization and targeted biopsies, thereby enhancing diagnostic yield. This review summarizes technological evolution from fiber-optic mother–baby systems to digital single-operator cholangioscopy and direct POCS, as well as the integration of image-enhanced endoscopy and emerging wide-channel scopes. Visual criteria for malignancy—tumor vessels, irregular granular or papillary/villous patterns, and friability—achieve high sensitivity and interobserver reliability with proposed classifications (Monaco, Mendoza). For cholangiocarcinoma, POCS-guided mapping biopsies precisely assess longitudinal intraepithelial tumor spread, informing R0 surgical planning. Randomized trials indicate higher or at least comparable sensitivity of POCS-guided biopsies relative to ERCP sampling, while novel forceps and larger working channels increase specimen size and reduce the number of biopsies. Artificial intelligence (AI) applied to POCS images shows promise for real-time risk stratification and improved targeting. Therapeutically, POCS guides intraductal lithotripsy with high clearance rates, and facilitates management in surgically altered anatomy in concert with endoscopic ultrasound-guided biliary drainage or transendosonographically/ guided created route procedure. Adverse events, chiefly pancreatitis and cholangitis, warrant attention to intraductal pressure control and CO2 insufflation. POCS has established an essential role in the diagnostic algorithm for biliary strictures; future advances will likely come from enhanced imaging, AI assistance, and next-generation digital cholangioscopes with larger biopsy devices.

Adverse Drug Reaction Relief System is intended for people who suffer adverse health effects from drugs despite their proper use, including over-the-counter (OTC) drugs. The decision-making data for the payment of relief benefits associated with OTC drugs and the instructions-for-use provided by community pharmacists and registered retailers were investigated. The results showed that the relief benefit nonpayment rate for OTC drugs was 3.9% and the number of cases was 9, of which 5 were due to improper use. Among the OTC drugs covered by relief benefits, the most common were schedule II pharmaceuticals, which were sometimes used in combination with prescription drugs. These results suggest that pharmacists and registered retailers should check for the use of concomitant drugs (e.g., with drug notebooks) at the time of the OTC drug sale. Pharmacists and registered retailers should provide a detailed explanation of the drugs to consumers and confirm that the information is understood, especially when schedule II pharmaceuticals or psychotropic drugs are sold. Additionally, information on the initial symptoms of an adverse drug reaction and treatment should be provided to prevent serious reactions. Follow-up with consumers during OTC drug use may also reduce the risk of misuse.