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image of a single-operator cholangioscopySingle-operator Cholangioscopy

Cholangioscopy is primarily used for the treatment of difficult bile duct stones and the evaluation of biliary strictures.

Cholangioscopy: Why It's Performed

A physician may choose to perform a cholangioscopy in the event that X-ray imaging from an endoscopic retrograde cholangiopancreatography is insufficient to make an adequate diagnosis or therapeutic intervention requires direct visualization. Using a single-operator cholangioscopy, your physician will be able to visualize and to examine the biliary, hepatic (liver), and pancreatic ducts.

Cholangioscopy: How to Prepare

  • You may not eat or drink eight to 12 hours prior to the procedure.
  • If you are on blood-thinning medication, ask your provider if you need to stop it prior to the procedure.

Cholangioscopy: What to Expect

During the Procedure

You will be asked to change into a gown before the procedure. You will be given a sedative by the anesthesiologist, who will be present to monitor your vital signs during the examination. You will not experience any sensation of gagging or choking. A mouthpiece will be placed between your teeth to protect your mouth. The endoscope does not interfere with your breathing.

After the Procedure

You will remain in a recovery room until most of the effect of the sedative has worn off. Because of sedation used during the procedure, you’ll need to make plans to have someone take you home.

Common Side Effects

  • Reactions to the sedative. The drugs used to sedate you may continue to cause drowsiness and may cause nausea and vomiting.
  • Sore throat. If the endoscope was guided down your esophagus, you may experience a sore throat. Lozenges help to soothe the throat.
  • Gas or cramps. A small amount of air may have been pumped into your digestive system to make it more accessible. This can result in gas, bloating or cramps after the procedure.

The New Era of Digital Cholangioscopy

New advancements in cholangioscopy is providing clearer imaging for diagnosis. Mouen Khashab, who specializes in therapeutic endoscopy at Johns Hopkins, discusses the new era of cholangioscopy, including when it is used, how it differs from prior devices and the advantages of using it over other therapies.