Intrahepatic Cholangiolithiasis Extraction During Endoscopic Retrograde Cholangiopancreatography Using a Disposable Ultrafine Peroral Cholangioscope

Hepatolithiasis refers to the presence of stones in the branching bile ducts above the confluence of the left and right hepatic ducts, often accompanied by extrahepatic bile duct stones. These stones can induce local infections and secondary bile duct strictures, making their discharge difficult and leading to severe complications. While endoscopic retrograde cholangiopancreatography (ERCP) is an effective minimally invasive method for treating cholangiolithiasis, it is often challenging to address hepatolithiasis using this technique. This article presents a step-by-step description of an ERCP procedure using a novel disposable ultrafine peroral cholangioscope. In this case, stones were successfully removed from a patient with intrahepatic cholangiolithiasis under direct visualization using the novel disposable ultrafine peroral cholangioscope. The therapeutic process highlighted the immediacy and efficiency of the peroral cholangioscopy in navigating intrahepatic bile ducts and extracting stones. This approach offers valuable insights for managing similar cases in the future, potentially benefiting more patients with comparable conditions.