Single-Session Percutaneous Cholangioscopy for High-Risk Patients with Biliary Stone Disease

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.