Gerges C, Vázquez AG, Tringali A, et al. - Given a higher complexity and invasiveness of percutaneous cholangioscopy (PC) than a transpapillary approach, with the necessity for a large percutaneous tract of 16 French (Fr) on average in order to advance standard percutaneous cholangioscopes, researchers here examined the feasibility, safety, and effectiveness of percutaneous single-operator cholangioscopy (pSOC) using the SpyGlass DS system in PC for diagnostic and therapeutic indications. They retrospectively analyzed data of 28 patients who underwent pSOC in 4 tertiary referral centers. A postsurgical altered anatomy was identified in 25/28 (89%) patients. Findings support pSOC to be a feasible, safe, and effective procedure for diagnostic and therapeutic indications. In clinical cases where gastrointestinal anatomy is altered, pSOC may be considered an alternative approach. It was identified to have the potential to lower peri-procedural adverse events and costs.