Choledochoscopy via the cystic duct: evaluation of a new ultrathin disposable choledochoscope.

A 2 mm fibreoptic choledochoscope with a disposable (resterilisable) flexible section was evaluated in 25 cadavers and 13 patients undergoing cholecystectomy. It was possible to pass the instrument via the cystic duct (CD) into the common bile duct (CBD) in 23 out of 25 cadavers and in 12 out of 13 patients. The CD diameter in cadavers was 2.4 mm (SD 0.5). Optical clarity was excellent and it was easy to pass into the duodenum, but proximal passage required mobilisation of the CD/CBD junction. This instrument may be a useful adjunct or even an alternative to intraoperative cholangiography.