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Abstract: Conventional mother--baby cholangioscopy has never gained wide acceptance and is available only in a minority of referral centers as the technology is technically difficult and expensive. Direct cholangioscopy (without a mother technology) using standard ultraslim endoscopes for biliary access is a novel, fascinating approach that could overcome several limitations of conventional cholangioscopy: It is a 1-operator procedure, there is no need for a second light source and processor, it provides excellent high-resolution images, and devices are equipped with a 2.0-mm diameter that allows the insertion of larger biopsy forceps and the use of a variety of endoscopic retrograde cholangopancreatography accessories. A direct cholangioscopy is demonstrated in a 45-year-old male patient who was admitted for painless jaundice after laparoscopic cholecystectomy for acute acalculous cholecystitis 6 weeks ago. This article is part of an expert video encyclopedia. READ THE FULL ARTICLE ON OUR OPEN ACCESS VIDEO JOURNAL & ENCYCLOPEDIA HERE: http://www.sciencedirect.com/science/... #VJGIEN #Video Journal GI Endoscopy #Carcinoma #Cholangiocarcinoma #ERCP #Neoplasia #Juandice #Elsevier openaccess #Direct transnasal cholangioscopy #endosonography