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A Two-Step Method for Percutaneous Transhepatic Choledochoscopic Lithotomy

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Operative choledochoscopy: experience with a rigid choledochoscope

R W Motson, A J Wood, L R De Jode

The British Journal of Surgery

|June 1, 1980

Summary

Choledochoscopy using a rigid scope helps find retained common bile duct stones and other issues. This review of 50 procedures shows its value in ensuring bile duct clearance post-exploration.

Area of Science:

Gastroenterology
Surgical Endoscopy

Background:

Retained common bile duct stones are a complication of bile duct exploration.
Accurate intraoperative assessment is crucial to prevent retained stones.

Purpose of the Study:

To evaluate the utility of rigid choledochoscopy in identifying retained common bile duct stones and other pathologies.
To assess the effectiveness of choledochoscopy in minimizing retained stones after common bile duct exploration.

Main Methods:

Review of 50 endoscopic procedures using a rigid choledochoscope.
Intraoperative findings during choledochoscopy were compared with postoperative cholangiography results.

Main Results:

Choledochoscopy identified retained stones or debris in 7 cases.

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An unsuspected neoplasm and a neoplastic stricture were diagnosed in 2 cases.

Postoperative cholangiography revealed retained stones in 2 cases not detected during choledochoscopy.

Conclusions:

Rigid choledochoscopy is a valuable tool for detecting retained common bile duct stones and other biliary tract pathologies.
While effective, choledochoscopy may not detect all retained stones, highlighting the importance of careful surgical technique and judicious use of postoperative imaging.