Percutaneous Tract Embolization Versus Conventional Drainage Following Percutaneous Transhepatic Cholangioscopy for Biliary Stones

ABSTRACT Background Percutaneous transhepatic cholangioscopy (PTCS) is a minimally invasive treatment for biliary diseases; however, postoperative biliary drainage can impair quality of life and cause complications. We developed a biodegradable blockage (BB) for tract embolization to replace drainage; this is the first study investigating this approach after PTCS. Methods In this prospective study, 10 patients with bile duct stones underwent PTCS with BB embolization (June‐August 2024). Outcomes and complications were recorded over 3 months. A 1:1 propensity‐matched control group from historical PTCS patients with standard drainage was established for comparison of hemoglobin levels and complications. Results BB placement was successful in all patients with no procedure‐related deaths. No significant differences were found between the embolization and drainage groups in operative time, hemoglobin changes, or complication rates, though the small sample size warrants caution. One patient in the embolization group had a Grade II complication, versus three complications (two Grade I, one Grade II) in the drainage group. The embolization group had no serious adverse events during follow‐up. Conclusion Tract embolization with BB appears to be a safe and feasible alternative to conventional drainage after PTCS. Larger randomized trials are needed for validation.