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Experience with the flexible fiberoptic choledochoscope

J J Bauer, B A Salky, I M Gelernt

    Annals of Surgery
    |August 1, 1981
    PubMed
    Summary
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    Flexible choledochoscopy improves common bile duct stone removal. This technique aids visualization and instrument passage, reducing retained calculi after surgery.

    Area of Science:

    • Gastroenterology and Hepatobiliary Surgery

    Background:

    • Retained calculi after common bile duct exploration remain a significant surgical challenge.
    • Improving the completeness of common duct exploration is crucial for reducing residual stones.

    Purpose of the Study:

    • To evaluate the utility of a flexible fiber optic endoscope (choledochoscope) for intraoperative and postoperative visualization and stone removal in the bile ducts.

    Main Methods:

    • Flexible choledochoscopy was performed 53 times in 52 patients (July 1978-November 1980).
    • The scope was used intraoperatively in 52 patients and postoperatively via a T-tube tract in one patient.
    • The choledochoscope allowed visualization and facilitated stone removal with integrated instruments.

    Main Results:

    • Choledochoscopy confirmed findings in various scenarios, including bile duct tumors, stenosis, and external compression.

    Related Experiment Videos

  • It identified residual stones missed by routine exploration in 9 patients (groups d and e), enabling their removal.
  • In 8 cases, stones were grasped or crushed using the choledochoscope's accessories; no septic complications occurred.

    • Conclusions:

    • Flexible choledochoscopy is a valuable tool for enhancing the completeness of common bile duct exploration.
    • It aids in the detection and removal of retained calculi, potentially reducing the incidence of residual stones.
    • The technique is safe and effective for visualizing intrahepatic and extrahepatic bile ducts.