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Updated: Jan 9, 2026

A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy
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Single-Session Percutaneous Cholangioscopy for High-Risk Patients with Biliary Stone Disease.

Jee Won Bae1, Abdifatah Omar1, Michelle Mai1

  • 1The Warren Alpert Medical School of Brown University, Providence, RI, 02903, USA.

Cardiovascular and Interventional Radiology
|December 4, 2025
PubMed
Summary

Single-operator percutaneous cholangioscopy effectively manages biliary stones in non-surgical patients, achieving high technical and clinical success with few complications. This minimally invasive approach offers a viable option for high-risk individuals.

Keywords:
CholangioscopyCholecystitisGallstone extraction

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Area of Science:

  • Gastroenterology and Hepatology
  • Interventional Radiology
  • Minimally Invasive Surgery

Background:

  • Biliary stone disease management often poses challenges for non-surgical candidates.
  • Percutaneous cholangioscopy offers a minimally invasive approach to the biliary tract.

Purpose of the Study:

  • To assess the technical and clinical success of single-operator, single-session percutaneous cholangioscopy for biliary stone removal.
  • To evaluate the safety and complication profile of this minimally invasive technique.

Main Methods:

  • Retrospective review of 37 percutaneous cholangioscopy-guided stone extraction procedures in 34 non-surgical patients.
  • Procedures were performed between March 2023 and August 2025, with patients undergoing either percutaneous cholecystostomy (PC) or percutaneous transhepatic biliary drainage (PTBD) prior to cholangioscopy.

Main Results:

  • Primary technical success rate of 91.2% (31/34), with 100% secondary technical success after repeat procedures.
  • Clinical success, defined by absence of recurrent symptoms, was achieved in 91.2% of patients at a median follow-up of 413 days.
  • Low complication rate, including one cystic duct injury and one pleural effusion (CIRSE Class 1a and 3b).

Conclusions:

  • Single-session percutaneous cholangioscopy is a highly effective and safe treatment for biliary stone disease in high-risk, non-surgical patients.
  • The procedure demonstrates high technical and clinical success rates with a favorable safety profile.
  • This technique represents a valuable therapeutic option for patients unsuitable for surgery or peroral endoscopic interventions.