Since 1981, we have been conducting research on percutaneous transhepatic cholecystoscopy through the sinus tract of percutaneous cholecystostomy and this method has been employed in 72 patients with gallbladder diseases. We have already reported on percutaneous transhepatic cholecystoscopy and its usefulness for the diagnosis of early gallbladder carcinoma. Histological diagnosis was possible on the basis of cholecystoscopic biopsies in all 21 patients with gallbladder carcinoma, including eight patients with early carcinoma. Percutaneous cholecystoscopy is a reliable method for making the differential diagnosis between carcinoma and polypoid lesions of the gallbladder, and the diagnosis of cancer extension on the mucosa to the cystic duct. This method is recommended as a further and final step for the early diagnosis of gallbladder carcinoma. We performed endoscopic lithotripsy with the Nd:YAG laser or electrohydraulic lithotripter, and treated 21 patients with cholecystolithiasis. We report here on the results and features of this method as a nonsurgical treatment for cholecystolithiasis.