[Common failure reasons and improvement ways in treatment of gallstones by choledochoscope in operation].

OBJECTIVE

To analyze common problems, failing causes and improvement ways for curing gallstones by choledochoscope in operation.

METHOD

To analyze a case group of 762 individual patients who had undergone choledochoscope operations in the period of Jan, 1995 approximately Sep, 2005.

RESULTS

136 cases are found with residual stones in the bile duct after the operations. Residual stone rate amounts to 17.8%. 55 patients are known that bile duct stones could not be remove completely during operations. 81 patients are proved that stones still remain in their bile ducts by T-tube cholangiography and choledochoscope after operations. Among them, 29 patients complicate with narrow in intrahepatic bile ducts and debouch of bile ducts, 39 patients complicate with stones of intrahepatic bile and variation of bile duct, 13 patients complicate with stones and narrow at the inferior segment of choledochus.

CONCLUSIONS

It is important to pay attention for bile duct variation and debouch of affection bile duct or inferior segment of choledochus stenosis. B-ultrasound is useful to reduce residual stones in operations. The surgeon should check different lengths of the duct methodically, and use the endoscope to explore the bile duct in order not to omit any stones.