Percutaneous cholangioscopy consists in the direct visualization of the biliary tree — for both diagnostic and therapeutic purposes — using a flexible endoscope that can be introduced percutaneously, either through a transhepatic tract created during biliary drainage or through a surgical T-tube tract. The technique was initially used in the early 1970s by some Japanese surgeons (Takada et al. 1974; Yamakawa et al. 1976) and then taken up around the world in the late 1980s and early 1990s by radiologists and surgeons (Picus et al. 1989; Nimura et al. 1989; Bonnel et al. 1991; Picus 1995; Rossi et al. 1996). More recently, many surgeons have begun to use a fine-caliber endoscope during laparascopic operations, to visualize the intrahepatic ducts or for therapeutic maneuvers (Lezoche and Paganini 1995).