About
When patients have acute cholecystitis (inflammation of the gallbladder) due to gallstones, sometimes one or many stones escape from the gallbladder and get stuck in the biliary tree before reaching the gut. By analogy, imaging your sink's garbage filter malfunctioning and allowing food balls to get stuck in the plumbing. The plumber can either retrieve the gunk from the sink-side (anterograde) or bottom-side (retrograde). Choledochoscopy is the anterograde analogy of a plumber pulling food out from the sink-side. In this technique, the surgeon first removes the gallbladder as per usual, but before finishing, the surgeon enters the bile duct (or plumbing pipes) from the opening made when removing the gallbladder (or disconnecting the sink from the plumbing pipes). It is an alternative to Endoscopic Retrograde CholangioPancreatography (ERCP), a procedure where the biliary tree (plumbing) is accessed from the gut (bottom-side) and the stones and sludge (food balls) are swept out that way. Both choledochoscopy (anterograde) and ERCP (retrograde) are very similar and even utilize that same blue-colored device.