The use of Intraoperative Choledochoscopy in Difficult Biliary Stones – a Report of 3 Cases in Current Clinical Settings

Choledocholithiasis occurs in 5-10% of patients with biliary lithiasis. Treatment strategies often involve endoscopic retrograde cholangiopancreatography (ERCP), which may be performed before, during, or after cholecystectomy. Choledochoscopy is an endoscopic procedure that allows direct visualization of the biliary tract for both diagnostic and therapeutic purposes. Intraoperative choledochoscopy has emerged as a valuable tool for the management of difficult choledocholithiasis during biliary tract exploration.The aim of this case series was to evaluate the effectiveness of intraoperative choledochoscopy in the laparo-endoscopic treatment of challenging stones. The series included three female patients with a mean age of 62 years, of whom two were classified as ASA-2. All patients had a history of at least one episode of acute cholecystitis. During choledochoscopy, a Dormia basket was used for stone extraction in two cases. There were no complications attributable to the laparo-endoscopic procedures, and biochemical parameters improved postoperatively.