Advertisement

Surgical Endoscopy

, Volume 2, Issue 3, pp 172–175 | Cite as

Intraoperative endoscopy of the biliary tract

  • Jesse E. Thompson
  • Robert S. Bennion
Original Articles

Summary

This is a prospective series of 328 operations for biliary stone disease in 326 consecutive patients. The overall operative mortality was 0.6%. Routine operative cholangiography was utilized during cholecystectomy, and this identified 19 patients (5.9%) with silent common bile duct stones. Common bile duct explorations were positive in 62 of 74 operations (83.8%). Biliary endoscopy was routinely performed during bile duct exploration. Unsuspected retained common duct stones were discovered postoperatively in 4.5% of these patients. Biliary endoscopy proved essential in the management of 18 patients with radiographically demonstrated distal bile duct obstruction. With patency confirmed by endoscopy, inappropriate duodenotomy and sphincter ablation were avoided in each of these 18 patients.

Key words

Biliary endoscopy Cholangioscopy Choledochoscopy 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Anderson TM, Pitt HA, Longmire WP (1985) Experience with sphincteroplasty and sphincterotomy in pancreatobiliary surgery. Ann Surg 201: 399–406PubMedGoogle Scholar
  2. 2.
    Arnold DJ (1970) 28, 621 cholecystectomies in Ohio: results of a survey in Ohio hospitals by the gallbladder survey committee, Ohio Chapter, American College of Surgeons. Am J Surg 119: 714–717PubMedCrossRefGoogle Scholar
  3. 3.
    Feliciano DV, Mattox KL, Jordan GL (1980) The value of choledochoscopy in exploration of the common bile duct. Ann Surg 191: 649–654PubMedGoogle Scholar
  4. 4.
    Gerber A, Apt MK (1982) The case against routine operative cholangiography. Am J Surg 143: 734–736PubMedCrossRefGoogle Scholar
  5. 5.
    Ghazi A, McSherry CK (1984) Endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 199: 21–27PubMedGoogle Scholar
  6. 6.
    Johnson AG, Hosking SW (1987) Appraisal of the management of bile duct stones. Br J Surg 74: 555–560PubMedGoogle Scholar
  7. 7.
    Kappes SK, Adams MB, Wilson SP (1982) Intraoperative biliary endoscopy: mandatory for all common duct operations? Arch Surg 117: 603–607PubMedGoogle Scholar
  8. 8.
    McSherry CK, Glenn F (1980) The incidence and causes of death following surgery for nonmalignant biliary tract disease. Ann Surg 191: 271–275PubMedGoogle Scholar
  9. 9.
    Miller BM, Kozarek RA, Ryan JA, Ball TJ, Traverso LW (1988) Surgical versus endoscopic management of common bile duct stones. Ann Surg 207: 135–141PubMedGoogle Scholar
  10. 10.
    Millward SF (1987) Post-exploratory cholangiography: is it a useful technique to check clearance of the common bile duct? Clin Radiol 33: 535–538CrossRefGoogle Scholar
  11. 11.
    Neoptolemos JP, Carr-Locke DL, Fraser I, Fossard DP (1984) The management of common duct calculi by endoscopic sphincterotomy in patients with gallbladders in situ. Br J Surg 71: 69–71PubMedGoogle Scholar
  12. 12.
    Nora PF, Berci G, Dorazio RA, Kirshenbaum G, Shores JM, Tompkins RK, Wilson SD (1977) Operative choledochoscopy: results of a prospective study in several institutions. Am J Surg 133: 105–110PubMedCrossRefGoogle Scholar
  13. 13.
    Rattner DW, Warshaw AL (1981) Impact of choledochoscopy on the management of choledocholithiasis: experience with 499 common duct explorations at the Massachusetts General Hospital. Ann Surg 194: 76–79PubMedGoogle Scholar
  14. 14.
    Schein CJ (1969) Biliary endoscopy: an appraisal of its value in biliary lithiasis. Surgery 65: 1004–1006PubMedGoogle Scholar
  15. 15.
    Senter KL, Berne CJ (1966) Significance of the nonpassage of radiopaque media through the ampulla of Vater during operative cholangiography. Am J Surg 112: 7–9PubMedCrossRefGoogle Scholar
  16. 16.
    Thompson JE, Bennion RS (1987) The role of endoscopy of the biliary tract in assessing the function of the ampulla of Vater. Surg Gynecol Obstet 165: 13–18PubMedGoogle Scholar

Copyright information

© Springer-Verlag 1988

Authors and Affiliations

  • Jesse E. Thompson
    • 1
    • 2
  • Robert S. Bennion
    • 1
    • 2
  1. 1.Department of SurgeryUCLA School of MedicineLos AngelesUSA
  2. 2.Department of SurgeryOlive View Medical CenterSylmarUSA

Personalised recommendations