The importance of postoperative choledochoscopy for management of retained biliary tract stones. 1980

T Yamakawa, and F Komaki, and J Shikata

From 1974-8, 808 postoperative choledochoscopy procedures, conducted by insertion of choledochofiberscope into the biliary tract through the sinus tract after the T-tube had been removed, were carried out in 292 patients at Teikyo University Hospital, Tokyo, Japan. In this series, 104 with retained biliary tract stones were encountered, and complete removal of stones was successfully carried out in 101, using postoperative choledochoscopy. Any failures of removal of retained biliary tract stones were attributed to improper insertion of the T-tube. The T-tube, of at least 18 French calibers should be inserted into the common bile duct at a right angle so as to obviate a tortuous sinus tract. THe follow-up study in cases of complete extraction of the retained biliary tract stones showed that this approach is most effective. Recurrent stone with a silk nidus was found in one patient in whom postoperative choledochoscopy had been performed one year previously. Reoperation was carried out in this particular case. All other patients have remained asymptomatic. Finally, we advise routine use of postoperative choledochoscopy as an adjunct to the T-tube cholangiography, in order to prevent the possibility of retained biliary tract stones.

UI MeSH Term Description Entries
D008875 Middle Aged An adult aged 45 - 64 years. Middle Age
D011182 Postoperative Care The period of care beginning when the patient is removed from surgery and aimed at meeting the patient's psychological and physical needs directly after surgery. (From Dictionary of Health Services Management, 2d ed) Care, Postoperative,Postoperative Procedures,Procedures, Postoperative,Postoperative Procedure,Procedure, Postoperative
D002758 Cholangiography An imaging test of the BILIARY TRACT in which a contrast dye (RADIOPAQUE MEDIA) is injected into the BILE DUCT and x-ray pictures are taken. Cholangiographies
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
D005260 Female Females
D005336 Fiber Optic Technology The technology of transmitting light over long distances through strands of glass or other transparent material. Fiber Optic Technologies,Optic Technologies, Fiber,Optic Technology, Fiber,Technologies, Fiber Optic,Technology, Fiber Optic
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
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

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