Biliary lithotripsy using super fine cholangioscopy with the deviced bended sheath

: Percutaneous transhepatic cholangioscopy (PTCS) is an useful technique to evaluate or treat biliary diseases, although PTCS is an invasive method for the patients. We used 5 F or 7 F of super fine cholangioscopy to treat two cases of choledocholithiasis after surgery without dilatation of drainage tract. We developed different types of bended sheath for supplement of lack of angle system in this cholangioscope. Furthermore, by using bended sheath, cholangioscopic view improved, because saline was injected at the same time via the sheath. We emphasize that super fine cholangioscope with bended sheath is a safe and useful modality for evaluation of biliary disease.