The majority of choledocholithiasis patients still require surgery. If the stones
are removed, the patient is cured. With modern cholangiography, the anatomy and the
location of the calculi can be immediately identified at the beginning of the operation.
In 6 % of cases, anomalies of surgical importance are detected. The general surgeon
is not an endoscopist and therefore, choledochoscopy is used infrequently. The introduction
of video techniques changed this pattern because the learning curve is shorter and
the procedure is easier and faster to perform with a higher success rate. A permanent
(objective) record of the findings and the visualization of the sphincter location
and function is an added bonus. If a stone is missed and the T-tube is inserted in
the proper fashion, the same video choledochoscope which is employed in the intraoperative
phase can be used in the postoperative period. In our experience (108 cases) we had
a success rate of 98 %. It can be performed on an outpatient basis. The surgeon should
be acquainted with intraoperative and postoperative biliary endoscopy to improve the
final outcome of this common and important surgical procedure.
Video choledochoscopy - Choledochoscopy - Intra- and postoperative biliary endoscopy
- Choledochoscopy through the T-tube tract
