Abstract No. 326 Clinical Outcomes of Outpatient Gallstone Organ-Sparing Cholangioscopy and Percutaneous Extraction (GO-SCOPE) in Patients Desiring to Preserve Their Organ

To assess clinical outcomes of Gallstone Organ-Sparing Cholangioscopy and Percutaneous Extraction (GO-SCOPE) with de novo access in patients with calculous biliary colic who elect to preserve their gallbladder.

This is a retrospective study of patients with calculous biliary colic who presented to a large academic center and had a percutaneous cholangioscopy with gallstone extraction between April 2024 and June 2025. All patients met standard indications for cholecystectomy after evaluation by a board-certified surgeon, but opted for percutaneous cholangioscopy with gallstone removal to preserve their gallbladder. Following gallstone extraction, a 8.5F to 14F cholecystostomy tube was left in place to allow decompression of the gallbladder and tract formation. Subsequent tube evaluation was performed approximately 1-3 weeks after gallstone extraction. If no residual stones were present and the cystic duct was patent, the tube was removed. Clinical outcomes for cholecystitis and cholangitis were gathered from the date their cholecystostomy tube was removed.

51 patients (mean age 46.7 yr, SD 11.4yr; 37 female and 14 male) with biliary colic secondary to cholelithiasis presented for elective outpatient percutaneous cholangioscopy and gallstone extraction. There was a 100% technical success rate in stone removal with no major adverse events per Society of Interventional Radiology criteria. Mean time between percutaneous gallstone extraction and biliary tube removal was 21.8 ± 9.5 days. One patient developed sepsis 17 days post-procedure as an outpatient prior to tube evaluation. One patient opted to have a cholecystectomy due to bile leakage from the gallbladder after the cholecystostomy tube was prematurely removed. Average clinical follow-up was 252 ± 113 days, with a median of 208 days (range 89 to 505 days). Patients reported complete or near-complete resolution of previous symptoms of biliary colic after GO-SCOPE. No patients had acute cholecystitis or cholangitis.

GO-SCOPE with de novo access resulted in symptom resolution, with no cases of biliary colic, acute cholecystitis, or cholangitis during follow-up. These findings suggest that gallbladder preservation with percutaneous cholangioscopy can provide resolution of biliary colic while preserving the gallbladder.