Electrohydraulic Lithotripsy for Hepatolithiasis With Novel VedVision Cholangioscope and New Biodegradable Stent...

Cholangioscopy has improved the management of complex biliary diseases; however, digital single-operator cholangioscopy (DSOC) still faces key limitations, especially in treating intrahepatic disease like hepatolithiasis and strictures, which often require surgery with significant mortality risk. This video case report illustrates the successful endoscopic treatment of an elderly woman with multiple left intrahepatic duct stones and a benign stricture. A next-generation 11-Fr high-definition cholangioscope (VedVision) was employed, offering enhanced imaging, improved maneuverability, and a dual-channel system enabling simultaneous guidewire and lithotripsy probe use. Electrohydraulic lithotripsy achieved complete stone clearance. A balloon-expandable biodegradable stent (UNITY-B), composed of magnesium alloy with polymer coating, was placed across the stricture to reshape it. Subsequent cholangioscopy confirmed correct positioning. This approach highlights a promising, non-surgical strategy for managing benign intrahepatic biliary disease. The biodegradable stent eliminates the need for removal, reducing the need for further interventions. However, long-term data and larger studies are necessary to confirm its safety and efficacy.