Utility of Cholangioscopy After Stone Removal for Common Bile Duct Stones in Patients with Surgically Altered Anatomy: A Single-Center Prospective Exploratory Study

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•Patients in whom common bile duct stones were identified on pre-procedural imaging (computed tomography, magnetic resonance cholangiopancreatography, ultrasonography, endoscopic ultrasonography, or balloon enteroscopy-assisted ERCP) and who were considered to require endoscopic stone removal.
•Patients with surgically altered anatomy (excluding Billroth I reconstruction).
•Patients with a distal bile duct diameter >=8 mm.
•Patients with a modified American Society of Anesthesiologists physical status (mASA-PS) classification of II or lower.
•Patients aged >=18 years who provided written informed consent to participate in the study.

•Patients in whom discontinuation of antithrombotic agents was considered difficult.
•Patients with cholangitis, severe jaundice (total bilirubin >5 mg/dL), or pancreatitis.
•Patients in whom single-session stone removal was considered difficult, including those with stacked stones, stones >15 mm in diameter, Mirizzi syndrome, or concomitant biliary stricture.
•Patients with a history of pancreatitis following balloon enteroscopy-assisted ERCP (BE-ERCP).
•Patients who were pregnant or possibly pregnant.
•Patients who were deemed unsuitable for participation in this study by the principal investigator or sub-investigators for medical or safety reasons.

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