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Updated: Aug 24, 2025
03:56
A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
Published on: September 13, 2022
2.5K
[Single-operator Cholangioscopy Guided Lithotripsy]
Jungha Shin1, Chi Hyuk Oh1, Seok Ho Dong1
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University College of Medicine, Seoul, Korea.
The Korean Journal of Gastroenterology = Taehan Sohwagi Hakhoe Chi
|October 25, 2022
Summary
Endoscopic retrograde cholangiopancreatography (ERCP) is standard for bile duct stones. Single-operator cholangioscopy offers a new approach for difficult stones not removed by conventional ERCP.
Area of Science:
- Gastroenterology and Hepatology
- Minimally Invasive Surgery
Context:
- Endoscopic retrograde cholangiopancreatography (ERCP) is the primary treatment for common bile duct (CBD) stones.
- Approximately 10% of patients present with difficult CBD stones requiring advanced interventions.
Purpose:
- To review the utility of single-operator cholangioscopy in managing difficult CBD stones.
- To highlight advances in cholangioscopy-guided lithotripsy for challenging cases.
Summary:
- Conventional ERCP with sphincterotomy and extraction fails in some CBD stone cases.
- Advanced techniques like balloon dilatation and mechanical lithotripsy are often needed.
- Cholangioscopy-guided electrohydraulic or laser lithotripsy, particularly with the SpyGlass DS system, enables direct visualization and treatment of difficult stones.
Impact:
- Single-operator cholangioscopy enhances the management of difficult CBD stones.
- This approach may improve stone clearance rates and reduce the need for more invasive procedures.
- It represents a significant advancement in endoscopic treatment for complex biliary stone disease.
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