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The two most common indications for use of cholangioscopy during endoscopic retrograde cholangiopancreatography (ERCP) are to assist in the evaluation of biliary strictures (i.e., to rule out malignancy) and to help break up large bile duct stones via laser or electrohydraulic lithotripsy. Relatively little data exist regarding the cost-effectiveness of these procedures, which is addressed in the current analysis based on clinical experience at two high-volume hospitals in Belgium.
Using data from 62 patients with large or complex stones and 49 patients with biliary strictures considered indeterminate for malignancy, the authors created decision-tree models to assess financial and clinical effectiveness of digital single-operator cholangiosc…