Double-balloon enteroscopy-assisted peroral cholangioscopy-guided electrohydraulic lithotripsy in a patient with surgically altered anatomy.

Toyonaga and colleagues describe double-balloon enteroscopy-assisted peroral cholangioscopy-guided electrohydraulic lithotripsy for evaluating intrahepatic bile ducts and managing stones in patients with surgically altered anatomy. Using a novel thin cholangioscope, this technique enables effective stone fragmentation and removal without scope exchange, highlighting its utility in anatomically challenging cases.