Published online Oct 20, 2020. doi: 10.5412/wjsp.v10.i2.3
Peer-review started: June 18, 2020
First decision: July 25, 2020
Revised: August 23, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: October 20, 2020
Core Tip: Cholangioscopy has been described in case reports and series to facilitate guidewire placement in difficult benign biliary strictures, especially in the setting of liver transplants. Most biliary strictures are successfully traversed with standard techniques utilizing hydrophilic guidewires during endoscopic retrograde cholangiopancreatography, but challenges with difficult wire placement can occur when the biliary tree consists of multiple strictures and sharp angulations. Here we describe a case of guidewire placement through a difficult malignant biliary stricture using single operator cholangioscopy, highlighting the versatility of cholangioscopy especially in anatomically challenging patients.