Single-Session Outpatient Gallstone Organ-Sparing Cholangioscopy and Percutaneous Extraction (GO-SCOPE) for...

To test the hypothesis that gallstone organ-sparing cholangioscopy and percutaneous extraction (GO-SCOPE) achieves high single-session technical success, durable symptom improvement, and an acceptable safety profile in patients with symptomatic calculous biliary colic who elect nonsurgical management despite eligibility for cholecystectomy.

This retrospective study evaluated consecutive patients who underwent GO-SCOPE between April 2024 and July 2025 at a single tertiary academic center. The procedure consisted of same-day percutaneous gallbladder access, cholangioscopy-assisted gallstone extraction with lithotripsy as needed, and placement of a percutaneous cholecystostomy or transcystic biliary drain for tract maturation. Sixty-six patients (mean age, 46.0 years; range, 25-72 years) underwent GO-SCOPE. Primary outcomes included technical success (removal of all visualized gallstones in a single session), clinical success (improvement or resolution of biliary colic symptoms), and 30-day adverse events classified according to the Society of Interventional Radiology (SIR) adverse event classification system. Secondary outcomes included residual or recurrent gallstones on follow-up imaging.

Single-session technical success was achieved in 60 (90.9%) of 66 patients; 6 required repeat cholangioscopy for residual stones. Mean time to tube removal was 21.3 days. Among 60 patients with 3-month follow-up imaging, 2 (3.3%) demonstrated asymptomatic subcentimeter gallstones. Clinical success was achieved in 59 (98.3%) of 60 patients at 3-month follow-up and 30 (96.8%) of 31 patients at 12-month follow-up. Four adverse events occurred, including 1 moderate and 3 severe.

GO-SCOPE demonstrated high technical and clinical success with an acceptable safety profile as an organ-sparing alternative to cholecystectomy in patients with symptomatic gallstone disease.