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Updated: Mar 29, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
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Percutaneous Transhepatic Cholangioscopy.

Sameer Ahmed1, Todd R Schlachter2, Kelvin Hong2

  • 1Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, MD.

Techniques in Vascular and Interventional Radiology
|November 29, 2015
PubMed
Summary
This summary is machine-generated.

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Percutaneous transhepatic cholangioscopy (PTCS) offers direct visualization for diagnosing biliary malignancies with over 95% accuracy and treating bile duct stones effectively, making it a safe and valuable interventional radiology procedure.

Area of Science:

  • Interventional Radiology
  • Gastroenterology
  • Hepatobiliary Medicine

Background:

  • The interventional radiologist's role in biliary disease management is expanding.
  • Percutaneous transhepatic cholangioscopy (PTCS) enables direct visualization of the biliary system.
  • It is particularly useful when a peroral approach is not feasible due to anatomical challenges.

Purpose of the Study:

  • To review the indications, techniques, outcomes, and complications of PTCS.
  • To provide readers with comprehensive knowledge of PTCS for biliary interventions.
  • To highlight the diagnostic and therapeutic capabilities of PTCS.

Main Methods:

  • Direct visualization of the biliary system via PTCS.
  • Endoscopically guided biopsy for lesion characterization.
Keywords:
ERCPbiliary interventioncholangioscopytranshepatic

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  • Assessment of tumor extent for surgical planning.
  • Treatment of obstructive biliary stones, including laser lithotripsy.
  • PTCS-guided stone removal.

    • Main Results:

    • PTCS demonstrates >95% accuracy in diagnosing biliary malignancies.
    • PTCS allows for differentiation between benign and malignant lesions.
    • Successful complete removal of biliary stones in ~90% of cases.
    • Severe complications occur in <8% of patients, indicating a favorable safety profile.

    Conclusions:

    • PTCS is a safe and effective procedure for diagnosing and treating biliary diseases.
    • It provides crucial diagnostic information and therapeutic options, especially in complex anatomies.
    • The review aims to enhance understanding and application of PTCS in clinical practice.