Intraoperative and postoperative biliary endoscopy (choledochoscopy). 1989

G Berci
UCLA School of Medicine.

Surgical exploration of the common bile duct is performed blindly, and perhaps this is one of the reasons the incidence of retained stones is higher than it should be. The introduction of the choledochoscope was promising, but a recent survey found that although a majority of hospitals where biliary surgery is performed have the instrument in the operating room, only a small percentage of surgeons use it routinely. This means that the general surgeon is not an endoscopist and choledocholithotomy cases are only 10 to 20 per cent of the existing biliary material. The introduction of the video choledochoscope shortened the learning curve for the surgeon significantly. The enlarged image can be seen conveniently from a distance with both eyes. Intraoperative stone retrieval requires four hands, and with video endoscopy, movements are coordinated, as the entire operating team can see the process. Therefore, the procedure is more precise and faster. The few missed stones can be removed with ease in the postoperative period through the T-tube tract. The procedure is safe and accurate and can be performed on an outpatient basis.

UI MeSH Term Description Entries
D007432 Intraoperative Period The period during a surgical operation. Intraoperative Periods,Period, Intraoperative,Periods, Intraoperative
D011184 Postoperative Period The period following a surgical operation. Period, Postoperative,Periods, Postoperative,Postoperative Periods
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
D013690 Television The transmission and reproduction of transient images of fixed or moving objects. An electronic system of transmitting such images together with sound over a wire or through space by apparatus that converts light and sound into electrical waves and reconverts them into visible light rays and audible sound. (From Webster, 3rd ed) Televisions
D042882 Gallstones Solid crystalline precipitates in the BILIARY TRACT, usually formed in the GALLBLADDER, resulting in the condition of CHOLELITHIASIS. Gallstones, derived from the BILE, consist mainly of calcium, cholesterol, or bilirubin. Biliary Calculi,Common Bile Duct Gall Stone,Common Bile Duct Gallstone,Gallstone,Biliary Calculi, Common Bile Duct,Common Bile Duct Calculi,Common Bile Duct Gall Stones,Common Bile Duct Gallstones,Gall Stone,Gall Stones,Gall Stones, Common Bile Duct,Gallstones, Common Bile Duct,Calculi, Biliary
D019723 Endoscopes Instruments for the visual examination of interior structures of the body. There are rigid endoscopes and flexible fiberoptic endoscopes for various types of viewing in ENDOSCOPY. Endoscope

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