Clinical efficacy of choledochoscopy using pancreaticobiliary imaging-guided catheter to diagnose and treat biliary pancreatitis via the cystic duct, common bile duct, and duodenum

This clinical study aimed to explore the clinical efficacy of performing a choledochoscopy with a 9FR disposable pancreaticobiliary imaging-guided catheter to diagnose and treat acute biliary pancreatitis caused by common bile duct stones. A retrospective analysis was conducted involving patients who underwent laparoscopy with a 9FR disposable pancreaticobiliary imaging-guided catheter. Endoscopy was conducted via the gallbladder duct, common bile duct, hepatopancreatic ampulla, duodenal papilla, and descending duodenal lumen between January 2020 and January 2024 at our institution. Clinical indicators were analyzed and postoperative treatment effects were monitored. Sixty-six patients underwent surgery, including fifty with secondary common bile duct stones and sixteen with primary common bile duct stones. The operative time ranged from 80 to 290 minutes ( 138.79 ± 36.86 minutes). Intraoperatively, blood loss ranged from 5 to 50 mL (13.03 ± 7.06 mL) and average postoperative lengths of hospital stays of 9.95 ± 2.43 days were recorded. All patients were followed up for 6 to 12 months. No pancreatitis, recurrence of common bile duct stones, bile fistulas, or stenosis of the common bile duct were observed. Abdominal ultrasound examination of the common bile duct and pancreas showed no abnormalities, and biochemical indicators were within normal ranges. Laparoscopy using a 9FR disposable pancreaticobiliary imaging-guided catheter through the gallbladder duct, common bile duct, hepatopancreatic ampulla, duodenal papilla, and descending duodenal cavity is beneficial for diagnosing and treating common bile duct microstones. The procedure can relieve biliary obstruction, curb further progression of acute biliary pancreatitis, accelerate the recovery process of postoperative gastrointestinal function, improve liver and pancreatic function in patients, and reduce the incidence of related complications. This technique is safe and feasible; however, the surgical difficulty is high. The operator must be skilled in laparoscopy and choledochoscopy, and minimally invasive surgical techniques. Cases must be strictly screened.