PERcutaneous transhepatic cholangioscopy using a new single-operator short CHOLangioscope (PERCHOL): a European feasibility study

Aims The aim was to assess the feasibility and safety of percutaneous endoscopic cholangioscopy using a new short, dedicated device.

Methods This is an observational, multicenter retrospective study. All patients who underwent percutaneous cholangioscopy using Spyglass Discover in 2020-2022 were included.

The clinical success, defined as the complete duct clearance or the performance of at least one cholangioscopy-guided biopsy, was assessed. The histopathological accuracy was assessed. The technical success and the adverse event rate were considered.

Results Fifty-one patients (60.2±15.9 years, 45.1% male) were included. Most presented with an altered anatomy (n=40, 78.4%) and biliary stones (n=34, 66.7%). The technique was mainly wire-guided (n=44, 86.3%) through a percutaneous sheath (n=36, 70.6%) at a median of 8.5 days from percutaneous drainage.

Cholangioscopy-guided electrohydraulic lithotripsy was performed in 29 cases (56.9%), combined with a retrieval basket (n=8, 27.6%). The clinical success was 96.6% requiring a median of 1 session. Seventeen patients (33.3%) underwent cholangioscopy-guided biopsies, with a clinical success and accuracy of 100% and 94.1%.

Overall, the technical success and adverse event rates were 100% and 7.6% in a median follow-up of 7 months.

Conclusions Percutaneous endoscopic cholangioscopy is effective and safe, requiring a low number of sessions for achieving duct clearance or accurate diagnosis.

Conflicts of interest

EPCR is consultant of Boston Scientific

Publication History

Article published online:
14 April 2023