“Importantly,


83.3% of patients


successfully had their cholecystostomy tube removed, signifying that this technique not only


facilitates immediate stone clearance but also contributes to long-term management success.”


also sets the stage for standardizing procedural practices across institutions.”


In addition to documenting the experiences of over 500 patients who underwent PCS procedures, researchers also submitted an abstract specifically evaluating the safety and efficacy of percutaneous transcystic cholangioscopy (PTC) to manage common bile duct (CBD) stones.


Managing CBD stones Additionally, the early results include the outcomes of 30 patients who received PTC—many of whom had comorbidities that made them unfit for surgery.


Many patients who undergo gallbladder decompression via a cholecystostomy tube also have CBD stones that require further intervention, Dr. Kamireddy said. Traditional management options include percutaneous transhepatic access or repeat endoscopic procedures, both of which can be technically challenging.


Arun Kamireddy, MD, MBBS


“Our study evaluated the safety and efficacy of PTC for managing common bile duct stones using a pre- existing cholecystostomy tube,” said Dr. Kamireddy. “Given the growing use of disposable, smaller profile cholangioscopes and advanced stone retrieval techniques, we wanted to assess whether this transcystic approach could provide a minimally invasive, time-saving


and cost-effective alternative to standard percutaneous or endoscopic methods.”


Researchers found that this was a highly effective approach, with a 95.3% technical success rate and a procedural success rate of 87.5%.


“The ability to access the CBD through the cystic duct without requiring new transhepatic access reduces procedure- related risks, shortens procedural times and minimizes radiation exposure,” Dr. Kamireddy said. “Importantly, 83.3% of patients successfully had their cholecystostomy tube removed, signifying that this technique not only facilitates immediate stone clearance but also contributes to long-term management success.”


In addition, researchers believe the low complication rate (1.6%), and the complete absence of pancreatitis further supports the technique’s safety, reinforcing that it should be considered a primary approach in select patients, particularly those with prior failed ERCP or contraindications for surgery.


“This study underscores the importance of optimizing existing access routes rather than creating new ones whenever possible,” Dr. Kamireddy said. “By utilizing the pre-existing cholecystostomy tube and the natural cystic duct pathway, this approach minimizes unnecessary interventions, reduces costs and enhances patient safety.”


28 IRQ | SUMMER 2025


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