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Single‐operator cholangioscopy (SOC) is a valuable diagnostic (e.g. stricture) and therapeutic (e.g. lithotripsy) platform for treatment of complex biliary diseases. Technical success rates, i.e. advancement up to a pre‐defined target lesion, are generally high. Anatomic factors, such as periampullary diverticula, however, may complicate scope insertion, for which a novel troubleshooter technique, designated the “long scope position insertion”, is presented here.

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Long‐scope position insertion for a challenging bile duct access by a novel digital single‐operator cholangioscope (SpyGlass DS) in periampullary diverticulum