Safety and Effectiveness of Large-Bore Percutaneous Cholangioscopy-Assisted Gallstone Retrieval for Inoperable...

Area of Science:

• Interventional Radiology
• Gastroenterology
• Biliary Interventions

Background:

• Symptomatic cholelithiasis poses a management challenge, particularly in patients with high surgical risk.
• Percutaneous biliary access offers an alternative, but large-bore techniques for cholangioscopy-assisted gallstone extraction are less established.

Purpose of the Study:

• To evaluate the safety and effectiveness of large-bore percutaneous biliary access for cholangioscopy-assisted gallstone extraction.
• To assess outcomes in patients with acute calculous cholecystitis who are poor surgical candidates.

Main Methods:

• Retrospective analysis of 30 patients undergoing large-bore (24 or 30 F) percutaneous cholangioscopy for gallstone extraction.
• Assessment of technical success, procedure duration, fluoroscopy time, symptom reduction, 3-month outcomes, and adverse events (AEs).

Main Results:

• Successful gallstone removal in a single session in 93.3% of patients.
• Facilitated extraction of large gallstones (0.5-4 cm) with mean procedure and fluoroscopy times of 105.4 and 21.7 minutes.
• 93.3% of patients were symptom-free at 3 months with no recurrence; overall AE rate was 6.7% (Grade 2 and 3), successfully managed.

Conclusions:

• Large-bore percutaneous biliary access is a safe and effective method for cholangioscopy-assisted gallstone extraction.
• This technique provides a viable option for managing symptomatic gallstones in high-risk surgical patients.