Cholangiography and Choledochoscopy Instruments

Cholangiography and choledochoscopy are essential techniques in modern hepatobiliary surgery, enabling accurate delineation of biliary anatomy and effective management of biliary pathologies, particularly choledocholithiasis. This chapter provides a comprehensive overview of the indications, instrumentation, and technical aspects required for performing intraoperative cholangiography and choledochoscopy. Key instruments such as cholangiography catheters, Olsen clamps, C-arm fluoroscopy systems, flexible choledochoscopes, Dormia baskets, and balloon catheters are discussed in detail. Practical tips, troubleshooting strategies, and safety considerations—especially regarding radiation exposure—are highlighted to enhance procedural success and minimize complications. Advances such as fluorescence cholangiography with indocyanine green, digital choledochoscopy systems, and improved lithotripsy techniques are also reviewed. A thorough understanding of these tools and techniques allows surgeons to improve diagnostic accuracy, ensure safe biliary exploration, and optimize patient outcomes in minimally invasive surgery.