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Overview

Cholangioscopy is a specialized endoscopic procedure that allows direct visualization of the bile ducts — the tubes that carry bile from the liver and gallbladder to the intestine. It is performed using a thin, flexible endoscope (cholangioscope), often inserted through an ERCP (Endoscopic Retrograde Cholangiopancreatography) scope for enhanced precision.

This advanced procedure helps in the diagnosis and treatment of bile duct stones, strictures, and tumors, allowing for targeted therapy and accurate biopsies without major surgery.

What is cholangioscopy?

Cholangioscopy is an endoscopic procedure used to look directly inside the bile ducts using a small camera attached to a flexible tube. It enables gastroenterologists to see, diagnose, and treat problems such as bile duct stones, blockages, or growths in real time.

Why is cholangioscopy performed?

Your doctor may recommend cholangioscopy if you have:

  • Bile duct stones (choledocholithiasis) not removable by standard ERCP
  • Unexplained bile duct narrowing (strictures)
  • Suspected bile duct tumors or cholangiocarcinoma
  • Persistent jaundice or abnormal liver function tests
  • Post-surgical bile duct injuries

It provides a clear, magnified view of the bile ducts for accurate diagnosis and targeted treatment.

How is cholangioscopy performed?
  • The procedure is performed under sedation or general anesthesia.
  • A duodenoscope (used in ERCP) is passed through the mouth into the small intestine.
  • Through this scope, a miniature cholangioscope is inserted directly into the bile ducts.

The doctor visualizes the ducts and may perform:

  • Stone removal or fragmentation (using laser or electrohydraulic lithotripsy)
  • Targeted biopsies of suspicious lesions
  • Ductal dilatation or stent placement, if needed
  • The entire procedure takes around 45–60 minutes.
Is cholangioscopy painful?

No. The procedure is not painful as it is done under sedation or general anesthesia. Patients may experience mild throat discomfort or bloating afterward, which subsides within a few hours.

Is cholangioscopy safe?

Yes. Cholangioscopy is safe and minimally invasive when performed by trained specialists. Minor risks include temporary nausea, mild pancreatitis, or infection — all of which are rare and manageable.

How is cholangioscopy different from ERCP?
AspectERCPCholangioscopy
VisualizationIndirect (X-ray guided)Direct (real-time camera view)
AccuracyHighEven higher — direct inspection
Therapeutic useStone removal, stentingTargeted stone removal, biopsy, tumor visualization
PrecisionRadiologicVisual and targeted

In many cases, cholangioscopy is performed as an add-on to ERCP for greater diagnostic accuracy and therapeutic precision.

What is recovery like after cholangioscopy?
  • Hospital stay: Usually same day or overnight observation
  • Diet: Resume liquids after 4–6 hours
  • Activities: Return to normal activities the next day
  • Follow-up: Based on findings (biopsy, stone removal, or stenting)

Most patients experience quick recovery and minimal discomfort.

What are the benefits of cholangioscopy?
  • Direct visualization of the bile ducts for accurate diagnosis
  • Allows biopsy and targeted therapy in a single procedure
  • Minimally invasive — no surgical incision
  • Short recovery and minimal complications
  • Helpful in cases where standard ERCP is inconclusive
Call to Action

If you are experiencing jaundice, bile duct stones, or unexplained liver test abnormalities, the Gastroenterology & Interventional Endoscopy Team at Baby Memorial Hospital (BMH) offers advanced Cholangioscopy for accurate diagnosis and minimally invasive treatment of complex bile duct conditions.

👉 Book an Appointment Online or visit BMH to consult our gastroenterology and hepatobiliary specialists.

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