How can cholangioscopy improve the management of intrahepatic stones?

Experience with endoscopic treatment of intrahepatic stones in 93 cases encountered over 13 years starting in 1974 was analyzed and the usefulness of the procedure is discussed in this paper. Postoperative cholangioscopy and percutaneous transhepatic cholangioscopy are easy, safe and reliable procedures because they can be carried out under both fluoroscopic and direct visual control. They can be safely and repeatedly carried out if the sinus tract is kept open. Preoperative percutaneous transhepatic cholangioscopy is an important tool in the diagnosis and treatment of intrahepatic stones, because it provides the important information necessary for selection of an appropriate therapeutic procedure. Different stone extraction techniques can be accurately carried out with endoscopic guidance, and stones that are visible are readily removable. A good prognosis can be expected when stones are completely extracted. With this approach, the author believes that the results of treatment for intrahepatic stones will be significantly improved.