Single-Operator Cholangioscopy for Large or Complex Bile Duct Stones

Modern peroral cholangioscopes have been commercially available for over a decade. While often used to evaluate and sample indeterminate biliary strictures, these devices can also be used to fragment large or complex bile duct stones via electrohydraulic or laser lithotripsy. Outcome data in this area remain relatively sparse.

In a newly reported multicenter, single-arm study, researchers prospectively evaluated outcomes of peroral cholangioscopy (POCS)–guided lithotripsy to treat choledocholithiasis in 156 patients with large or multiple stones, stones above strictures, intrahepatic stones, or other challenging clinical presentations. Most had previously undergone failed attempts at stone extraction.

A total of 174 procedures were performed …