Percutaneous transhepatic cholangioscopic lithotripsy (PTCSL) is a standard procedure for hepatolithiasis, often requiring multiple sessions. We aimed to evaluate a new one-step PTCSL technique designed to enable single-session lithotripsy without preliminary drainage or sequential dilation. A retrospective analysis of 48 patients treated from January 2013 to December 2020 was conducted. This innovative technique used ultrasound guidance to insert an 8Fr needle into the biliary system, followed by tract dilation and direct nephroscope insertion for stone lithotripsy and extraction. The results were promising, with an initial complete stone clearance rate of 74.2%. The average procedure time was 86.7 minutes, and although minor complications were reported in 75% of patients, there were no major adverse events. Notably, stone recurrence was observed in 35.5% of patients at the one-year follow-up. The one-step PTCSL significantly reduced the number of procedures, overall treatment duration, and hospitalization length compared to traditional methods. Our findings indicate that the one-step PTCSL is effective and safe, offering a significant improvement over multi-step procedures by achieving rapid clearance of intrahepatic stones in a single session. This approach could represent a substantial advancement in the treatment of hepatolithiasis, suggesting further investigation and potential adoption in clinical practice is warranted.

Yan Jiao has completed his PhD at the age of 27 years from Jilin University. He is a surgeon of Department of Hepatobiliary and Pancreatic surgery in First Hospital of Jilin University. He has published more than 50 papers in reputed journals and has been serving as an editorial board member of repute.