Diagnostic and therapeutic cholangioscopy performed by various accesses to the bile ducts

   Aim. To summarize data, define indications and estimate outcomes of cholangioscopy performed by various accesses to the bile ducts.   Materials and methods. In the period of 2017–2024, 68 cholangioscopies were performed in 24 (35.3 %) men and 44 (64.7 %) women. The age of patients ranged from 18 to 85 years (mean age comprises 61 years). 10 (14.7 %) cholangioscopies were performed by retrograde access, 42 (61.8 %) by antegrade access, and 16 (23.5 %) were performed intraoperatively.   Results. The total amount of interventions include 21 (30.9 %) lithoextractions, 16 (23.5 %) targeted biopsies, 12 (17.6 %) recanalizations of anastomosis strictures, and 1 (1.79 %) case involved a retrieval of the “lost” bile duct stent. In 7 (10.3 %) cases cholangioscopy failed due to a small diameter of the bile ducts.   Conclusion. Contemporary minimally invasive endoscopic methods considerably enlarge the possibilities for treatment of complex lesions of the bile ducts. Antegrade cholangioscopy contributes to a wider application of modern technologies for direct examination of the bile ducts and to expansion of the range of therapeutic manipulations. The introduction of antegrade cholangioscopy avoids extensive traumatic reconstructive interventions with their potential risk of complications.