OUR EXPERIENCE WITH DIAGNOSTIC AND THERAPEUTIC CHOLEDOCHOSCOPY.

Area of Science:

• Gastroenterology
• Surgical Innovation
• Biliary Tract Surgery

Background:

• Common bile duct (CBD) exploration is performed to identify and remove gallstones.
• Retained CBD stones can lead to complications, necessitating further interventions.
• Intraoperative cholangiography may not always detect all CBD stones.

Purpose of the Study:

• To evaluate the utility of flexible choledochoscopy in CBD exploration for suspected stones.
• To assess the impact of choledochoscopy on the incidence of retained CBD stones.

Main Methods:

• Flexible choledochoscopy was employed in 16 patients undergoing CBD exploration.
• Patients had suspected CBD stones, with some having normal intraoperative cholangiograms.
• Postoperative T-tube cholangiograms and clinical follow-up were conducted.

Main Results:

• Choledochoscopy identified CBD stones in 4 patients with previously normal intraoperative cholangiograms.
• All 16 patients had normal T-tube cholangiograms between postoperative days 10-14.
• No patients experienced symptoms of retained stones during 6-19 months of follow-up.

Conclusions:

• Flexible choledochoscopy is a valuable tool for enhancing the detection of CBD stones during exploration.
• Its use may significantly reduce the incidence of retained CBD stones.
• This technique improves diagnostic accuracy and patient outcomes in biliary surgery.