Direct Cholangioscopy With a Double-Balloon Enteroscope for Bile Duct Stones in a Patient After Distal Gastrectomy With Billroth-II Reconstruction.

With accompanying video, Sakurai and colleagues described a peroral direct cholangioscopy technique using a double-balloon enteroscope to treat bile duct stones after Billroth II gastrectomy. Direct insertion of the enteroscope into the bile duct eliminated scope exchange, enabling precise device manipulation, broader accessory selection, and shorter procedure time.