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Postoperative percutaneous choledochoscopy.

T J Wieman1, T S Corey, E Shively

  • 1Department of Surgery, University of Louisville School of Medicine, James Graham Brown Cancer Center, Kentucky 40292.

The American Surgeon
|February 1, 1989
PubMed
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Postoperative percutaneous choledochoscopy (PC) safely diagnoses and treats complex biliary issues like stones and strictures. This minimally invasive approach can help surgeons manage challenging conditions and potentially avoid repeat surgeries.

Area of Science:

  • Gastroenterology
  • Surgical Endoscopy
  • Biliary Tract Disease

Background:

  • Percutaneous choledochoscopy (PC) is an evolving tool for complex biliary tract disease.
  • Access to the biliary tree is typically achieved via T-tube tracts or biliary-enterocutaneous fistulas.

Purpose of the Study:

  • To retrospectively evaluate the efficacy and safety of postoperative percutaneous choledochoscopy (PC).
  • To assess PC's role in diagnosing and managing conditions such as choledocholithiasis, strictures, and cholangiocarcinoma.

Main Methods:

  • Retrospective review of 27 PC procedures performed on 22 patients between 1980 and 1987.
  • Procedures accessed the biliary tree through T-tube tracts (18 patients) or biliary-enterocutaneous fistulas (4 patients).
  • Indications included suspected choledocholithiasis, strictures, sclerosing cholangitis, and cholangiocarcinoma.

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Main Results:

  • PC was performed 16 times for suspected choledocholithiasis, with stones found in all 13 cases and successful extraction in 11.
  • Two patients received stents via PC, and nine procedures were for biopsies or stricture evaluation.
  • Diagnoses included benign strictures, sclerosing cholangitis, and cholangiocarcinoma; two minor complications were noted.

Conclusions:

  • Postoperative percutaneous choledochoscopy (PC) is a safe and effective method for managing complex biliary problems.
  • PC can aid surgeons in diagnosis and treatment, potentially avoiding re-operation in select patients.