Direct percutaneous cholangioscopy via left lobe of the liver in the context of intrahepatic choledocholithiasis in a patient with Roux-en-Y hepatico-jejunostomy

Abstract Text Percutaneous direct cholangioscopy offers an alternative for inaccessible biliary tree through the gastrointestinal tract. A 56-year-old male patient with a history of laborious cholecystectomy and intraoperative injury of the extrahepatic biliary system for which he had undergone hepatico-jejunostomy Roux-en-Y type, had intermittent episodes of cholangitis from 5 months that were self-limiting with antibiotic conservative treatment. Due to incipient inflammatory lesions of the hepatic parenchyma based on MRI and intrahepatic choledocholithiasis of the right lobe of the liver, an attempt was initially made to find the hepatico-jejunostomy with a therapeutic endoscope with direct vision unsuccessfully. Under fluoroscopic guidance, percutaneous left lobe catheterization was performed. Then, through the catheter, a cholangioscope was inserted and electro-hydraulic lithotripsy crushed numerous gallstones [1].

Video http://data.process.y-congress.com/ScientificProcess/Data//106/570/1428/dd5644eb-7762-4dcc-8bf8-954bb64a3d4e/Uploads/16849_galanopoulos.mp4

 

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Conflicts of Interest

Authors do not have any conflict of interest to disclose.

• References

• 1 Papaefthymiou A, Gkolfakis P, Basiliya K, Facciorusso A, Ramai D, Gerges C, Tziatzios G, Phillpotts S, Webster GJ.. Performance and safety of percutaneous cholangioscopy: a systematic review and meta-analysis. Ann Gastroenterol 2024; 37 (2): 225-234 Epub 2024 Feb 18. PMID: 38481781; PMCID: PMC10927623

Publication History

Article published online:
27 March 2025