Introduction:

Endoscopic vision of the bile and pancreatic ducts has been performed for two decades. However, its application in the daily practice in endoscopy units is rare. The modifications made in recent years to the cholangioscope provide a very important improvement in its operation, and in combination with fiber optics, have allowed the treatment of difficult-to-handle lithos, both in the bile duct and the main pancreatic duct. Description of the first case treated by cholangioscopy with SpyGlass DS (Boston Scientific) and laser lithotripsy in Mexico. Resolution of choledocholithiasis without complications. The improvements made to this endoscope allow for better functionality. The application of this technology provides a new therapeutic tool in the safe resolution of difficult-to-handle lithos, as we describe in this case.