Feature
The future of biliary disease management
Early data from the National Cholangioscopy Registry
This article originally appeared in the 2025 SIR Today coverage.
arly results from the National Cholangioscopy Registry provide insight into the safety and efficacy of various percutaneous
cholangioscopy (PCS) procedures in biliary disease management.
A landmark registry The National Cholangioscopy Registry included 527 patients who underwent 851 PCS procedures. The registry, which was supported with funding from SIR Foundation, pulled data from 17 clinical sites across the United States, thereby providing researchers with insights into procedural effectiveness and emerging trends.
“Despite the growing interest in PCS as a minimally invasive alternative for managing biliary diseases, large-scale multicenter data have been scarce,” said Arun Kamireddy, MD, MBBS.
While endoscopic techniques like endoscopic retrograde cholangiopancreatography (ERCP) are well established, PCS data is largely limited to small, single-institution experiences, despite the vital role it plays in treating patients with altered anatomy or failed endoscopic access, he said.
“We recognized the need for robust data to better inform clinical decision-making and potentially shape future guidelines,” Dr. Kamireddy said. “Our objective was to provide insights into procedural indications, technical and clinical
success rates, anesthesia practices and complication profiles, ultimately defining the role of PCS in contemporary interventional radiology practice.”
The study, which represents the largest multicenter analysis of PCS to date, found that PCS is a highly effective and safe procedure, with technical success achieved in 97.1% of cases and clinical success in 86.4%.
“These results affirm PCS as a reliable alternative for managing biliary stones and strictures, especially in complex clinical scenarios,” Dr. Kamireddy said.
Notably, researchers found that both reusable and disposable scopes yielded comparable outcomes, which has implications for cost-effectiveness and infection control.
“Additionally, the relatively low complication rate (3.6%) and high rate of successful tube removal (71.8%) highlight the favorable post-procedural outcomes associated with PCS,” Dr. Kamireddy said. “By providing multicenter, real-world data, our study not only validates the utility of PCS but
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