Historical Perspective on the Treatment of Choledocholithiasis: Lessons Learned and Techniques Prior to the Laparoscopic Era

  • George Berci


This chapter mentions briefly the history of gallbladder disease and the early stages of gallstone diagnostic techniques. The major focus of this chapter is the description and impact of intraoperative cholangiography (IOC) as well as the value of decreasing the occurrence of bile duct injuries. There are significant improvements in early detection (during primary surgery) with avoidance of additional severe complications. The other major item reviewed is the use of improved intraoperative choledochoscopy in the removal of common bile duct (CBD) stones. The aim of this communication is that hopefully surgeons will consider using proper IOC during biliary surgery and reduce the high incidence of bile duct injuries (BDI) as well as perform removal of CBD stones (10% of cholecystectomies) in one surgery instead of two procedures.


Cholangiography Gallstones Cholecystectomy Choledochoscope History Intraoperative cholangiography Intraoperative choledochoscopy 



I would like to express my thanks to Marc Arizmendez, Senior Media Specialist and Assistant, and Barbara Rosette and Susan Frederick for helping me to put this chapter together.


  1. 1.
    Praderi R, Hess W. Brief history of biliary and pancreatic diseases. In: Hess W, Berci G, editors. Text book of biliary pancreatic diseases, vol. 4. Piccin: Padova; 1997.Google Scholar
  2. 2.
    Bobbs JS. Case of lithotomy of the gallbladder. Indianapolis: Trans Indiana State Med Soc. 1868;18:68.Google Scholar
  3. 3.
    Sims JM. Cholecystostomy in dropsy of the gallbladder. Br Med J. 1879;8:811.Google Scholar
  4. 4.
    Courvoisier LG. Kasuistisch statistiche beitraege. Leipzig: Vogel; 1890.Google Scholar
  5. 5.
    Langenbuch C. Ein fall von extirpation der gallenblase wegen chronischer cholelithiasis. Berl Klin Wschr. 1882;19:725.Google Scholar
  6. 6.
    Ohage J. The surgical treatment of diseases of the gallbladder. Med Newsl. 1886;1:202–6.Google Scholar
  7. 7.
    Hatch TL. Owatonna, Minn. in Northwestern Lancet, St. Paul. 1886. vol. VI, No. 3.Google Scholar
  8. 8.
    Kehr H. Practice der gallenwege-chirurgie. Munchen: Lehmann; 1913.Google Scholar
  9. 9.
    Morgenstern L. Halsted nemesis. Surg Endosc. 1994;8:1165–7.CrossRefGoogle Scholar
  10. 10.
    Halsted W. Contribution to the surgery of the bile passages, especially of the common bile duct. Johns Hopkins Hosp Bull. 1900;11:1.Google Scholar
  11. 11.
    Mayo WJ. Some observations on the surgery of the gallbladder and bile ducts. Ann Surg. 1899;30:452.CrossRefGoogle Scholar
  12. 12.
    Graham E, Cole W. Roentgenologic examination of the gallbladder preliminary report of a new method utilizing the intravenous injection of tetrabromphenolphthalein. JAMA. 1924;82:613–4.CrossRefGoogle Scholar
  13. 13.
    Graham E, Cole W, Copher G, Moore S. Diseases of the gall bladder and bile ducts. Philadelphia: Lea & Febiger; 1928.Google Scholar
  14. 14.
    Reich A. Accidental injection of bile ducts with petrolatum and bismuth paste. JAMA. 1918;71:1555.CrossRefGoogle Scholar
  15. 15.
    Tenney CF, Patterson SH. Injection of the bile ducts with bismuth paste. JAMA. 1922;78:171.CrossRefGoogle Scholar
  16. 16.
    Mirizzi PL. La Cholangiografia durante las Operaciones de las vias Biliares. Bol Soc Cir Buenos Aires. 1932;16:1133.Google Scholar
  17. 17.
    Mirizzi PL. Operative cholangiography. Surg Gynecol Obstet. 1937;65:702.Google Scholar
  18. 18.
    Hicken NF, Best RR, Hunt HB. Cholangiography. Ann Surg. 1936;103:210.CrossRefGoogle Scholar
  19. 19.
    Glenn F. Exploration of the common bile duct. Ann Surg. 1940;112(1):64–79.CrossRefGoogle Scholar
  20. 20.
    Colcock BP, Perey B. Exploration of the common bile duct. Surg Gynecol Obstet. 1964;81:20–4.Google Scholar
  21. 21.
    Mack EA, Saito C, Goldfarb S, Crummy AB, Thistle JL, Carson FL, Babayan VK, Hoffman AF. A new agent for gallstone dissolution. Surg Forum. 1978;24:438.Google Scholar
  22. 22.
    Burhenne JJ. Nonoperative retained biliary tract stone extraction. Am J Roentgenol. 1973;117:388–99.CrossRefGoogle Scholar
  23. 23.
    Yamakawa T, Mieno K, Nogucki T, Shikata J. An improved choledochofiberscope and non-surgical removal of retained biliary calculi under direct visual control. Gastrointest Endosc. 1976;22:160–4.CrossRefGoogle Scholar
  24. 24.
    Berci G, Hamlin JA. A combined fluoroscopic and endoscopic approach for retrieval of retained stones through the T-Tube tract. Surg Gynecol Obstet. 1981;153:237–40.PubMedGoogle Scholar
  25. 25.
    Blumgart LH, Fong Y. Surgery of the liver and bile duct. 3rd ed. New York: Saunders; 2000.Google Scholar
  26. 26.
    Smith S, Engel C, Averhook B, Longmire WP. Problems of retained and recurrent common bile duct stones. JAMA. 1957;164:231–6.CrossRefGoogle Scholar
  27. 27.
    Hicken NF, McAllister JA, Walker G. The problems of retained common duct stones. Am J Surg. 1959;97:173–83.CrossRefGoogle Scholar
  28. 28.
    Schein CJ, Stern WZ, Jacobson HG. Residual stones. In: Schein CJ, editor. The common bile duct. Springfield: C. C. Thomas; 1966. p. 266–71.Google Scholar
  29. 29.
    Corlette MB, Achatzky S, Ackroyd F. Operative cholangiography and overlooked stones. Arch Surg. 1978;113:729–33.CrossRefGoogle Scholar
  30. 30.
    Gartell PC, McGinn FP. Choledochoscopy: are stones missed? A controlled study. Br J Surg. 1984;71:767–70.CrossRefGoogle Scholar
  31. 31.
    Cuschieri A, Berci G. Common bile duct exploration. Boston: Martinus-Nijhoff; 1984. p. 54–61.CrossRefGoogle Scholar
  32. 32.
    Berci G, Hamlin JA. Retrieval of retained stones. In: Berci G, Hamlin JA, editors. Operative biliary radiology. Baltimore: Williams & Wilkins; 1981. p. 147–58.Google Scholar
  33. 33.
    Lackner J, Volkel L. Die technik der intraoperative cholangiographie unter verwendung des roentgen-bildverstaerker. Roentgenbl. 1957;10:119.Google Scholar
  34. 34.
    Grace RH, Peckar VG. The value of operative cholangiography using an image intensifier and television monitor. Br J Surg. 1968;55:993.CrossRefGoogle Scholar
  35. 35.
    Berci G, Hamlin JA. Operative biliary radiology. Baltimore: Williams & Wilkins; 1981. p. 17Google Scholar
  36. 36.
    Mallet-Guy P. Television radioscopy during operations on the biliary passages. Surg Gynecol Obstet. 1958;106(6):747–8.PubMedGoogle Scholar
  37. 37.
    Donna Earley, Chapter 4: Radiation Hazard in Berci G, Hamlin JA. Operative Biliary Radiology. Baltimore: Williams & Wilkins; 1981. p. 23–38.Google Scholar
  38. 38.
    Lee KH. Radiation safety consideration in fluoroscopy. In: Berci G, Cuschieri A, editors. Bile ducts and ductal stones. Philadelphia: Saunders; 1996.Google Scholar
  39. 39.
    Berci G, Hamlin J. Operative biliary radiology. Baltimore: Williams; 1981. p. 202–13.Google Scholar
  40. 40.
    Berci G, Hunter J, Morgenstern L, Arregui M, Brunt M, Carroll B, et al. Laparoscopic cholecystectomy: first do no harm; second, take care of bile duct stones. Surg Endosc. 2013;27(4):1051–4.CrossRefGoogle Scholar
  41. 41.
    Nitze M. Eine neu beobachtung und untersuchungsmethode, D. Harnblase. Wien Med Wochenschr. 1879;24:649.Google Scholar
  42. 42.
    Bakes J. Die choledochopapilloskopie, nebst bemerkungen über hepaticus drainage und dilatation der papille. Arch Klinische Chirurgie. 1923;126:473–83.Google Scholar
  43. 43.
    McIver MA. Instrument for visualizing interior of the common duct at operation. Surgery. 1941;9:112.Google Scholar
  44. 44.
    Wildegans H. Die operative gallengangsendoskopie. Munich: Urban & Schwarzenberg; 1960.Google Scholar
  45. 45.
    Schein CJ, Stern WZ, Hurwitt ES, Jacobson HG. Cholangiography and biliary endoscopy as complementary methods of evaluating the bile ducts. Am J Roentgenol Radium Therapy, Nucl Med. 1963;89:864–75.Google Scholar
  46. 46.
    Berci G, Kont LA. A new optical endoscope with special reference to urology. Br J Urol. 1969;41:564–71.CrossRefGoogle Scholar
  47. 47.
    Shore JM, Morgenstern L, Berci G. An improved rigid choledochoscope. Am J Surg. 1971;122:567–8.CrossRefGoogle Scholar
  48. 48.
    Nora PF, Berci G, Dorazio PA, Kirshenbaum G, Shore JM, Tompkins RK, Wilson SD. Operative choledochoscopy. Am J Surg. 1977;133:105–10.CrossRefGoogle Scholar
  49. 49.
    Feliciano D, Mattox K, Jordan G. The value of choledochoscopy in exploration of the common bile duct. Ann Surg. 1980;191:649–53.CrossRefGoogle Scholar
  50. 50.
    Rattner DW, Warshaw AL. Impact of choledochoscopy on the management of choledocholithiasis. Experience with 499 common duct explorations at the Massachusetts General Hospital. Ann Surg. 1981;194(1):76–9.CrossRefGoogle Scholar
  51. 51.
    Cuschieri A, Berci G, Hamlin JA, Paz-Partlow M. Common bile duct exploration: intraoperative investigations in biliary tract surgery. Boston: Martinus Nijhoff Publishers; 1984.CrossRefGoogle Scholar
  52. 52.
    Berci G, Shulman AG, Morgenstern L, Paz-Partlow M, Cuschieri A, Wood RA. Television choledochoscopy. Surg Gynecol Obstet. 1985;160:176–7.PubMedGoogle Scholar
  53. 53.
    Shore JM, Berci G. An improved flexible cholangioscope. Endoscopy. 1976;8:41–2.PubMedGoogle Scholar
  54. 54.
    Phillips P, Berci G, Barber K, Williams J. The role of choledochoscopy: the eternal problem of how to remove a CBD stone. Surg Innov. 2015;22(5):540–5.CrossRefGoogle Scholar
  55. 55.
    Phillips E, Berci G, Barber K. The role of the video-choledochoscopy. J Surg Innovation. 2016;23:546–9.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of SurgeryCedars-Sinai Medical CenterLos AngelesUSA

Personalised recommendations