Choledochoscopy and common bile duct exploration. 1990

B R Wheeler, and G Anigian, and G Stephens, and G M Larson
Department of Surgery, University of Louisville School of Medicine, Kentucky.

Common bile duct (CBD) exploration is often indicated when cholecystectomy is performed for gallstone disease. Choledochoscopy may help to decrease the incidence of retained common duct stones. The present study reviews 97 consecutive CBD exploration cases performed between 1980 and 1988, in order to evaluate the authors' experience with flexible choledochoscopy and CBD exploration. Fifty-nine patients had CBD exploration plus flexible choledochoscopy and 38 underwent CBD exploration alone. Retained stones were found postoperatively in ten per cent of the patients who had only CBD exploration versus four per cent in the choledochoscopy group. The retained stones in five patients were later removed by percutaneous basket retrieval (3), flush irrigation (1), and choledochoscopy (1). Flexible choledochoscopy detected additional stones after routine CBD exploration in 12 patients, clarified T-tube cholangiograms in four patients, and aided stone extraction in two patients. For these reasons, and because choledochoscopy was associated with a lower incidence of retained stones, the authors believe this procedure is a worthwhile addition in most cases of CBD exploration.

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D002763 Cholecystectomy Surgical removal of the GALLBLADDER. Cholecystectomies
D002769 Cholelithiasis Presence or formation of GALLSTONES in the BILIARY TRACT, usually in the gallbladder (CHOLECYSTOLITHIASIS) or the common bile duct (CHOLEDOCHOLITHIASIS). Gallstone Disease,Cholelithiases,Gallstone Diseases
D003135 Common Bile Duct The largest bile duct. It is formed by the junction of the CYSTIC DUCT and the COMMON HEPATIC DUCT. Choledochus,Bile Duct, Common,Common Bile Ducts,Duct, Common Bile
D004724 Endoscopy Procedures of applying ENDOSCOPES for disease diagnosis and treatment. Endoscopy involves passing an optical instrument through a small incision in the skin i.e., percutaneous; or through a natural orifice and along natural body pathways such as the digestive tract; and/or through an incision in the wall of a tubular structure or organ, i.e. transluminal, to examine or perform surgery on the interior parts of the body. Endoscopic Surgical Procedures,Surgical Procedures, Endoscopic,Endoscopic Surgical Procedure,Endoscopy, Surgical,Surgical Endoscopy,Surgical Procedure, Endoscopic,Procedure, Endoscopic Surgical,Procedures, Endoscopic Surgical
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man

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