Thompson J E, Bennion R S
Surg Gynecol Obstet. 1987 Jul;165(1):13-8.
In a prospective series of 53 consecutive explorations of the common bile duct, there were 12 patients in whom no contrast material entered the duodenum on postexploratory cholangiography. In 11 of these patients, the choledochoscope had been used to visualize the ductal anatomy and in each instance the ampulla of Vater was visualized from within and judged to be patent. Calibration, not dilation of the ampulla was performed upon ten of the patients. Transient edema or spasm of the ampulla secondary to operative trauma, stone removal or underlying disease was diagnosed and in each patient the operation was terminated after the cholangiogram. Follow-up cholangiography in each instance demonstrated a patent ampulla, free flow into the duodenum and no strictures or stones. It is concluded from these data that with operative choledochoscopy the anatomy and pathologic characteristics of the biliary tract can be visualized and the patency of the ampulla of Vater can be assessed.
在对53例连续进行胆总管探查的前瞻性系列研究中，有12例患者在探查后胆管造影时无造影剂进入十二指肠。在这些患者中的11例，已使用胆管镜观察胆管解剖结构，且在每一病例中均从内部观察到 Vater壶腹并判定其通畅。10例患者进行了壶腹校准而非扩张。诊断为手术创伤、结石清除或潜在疾病继发的壶腹短暂水肿或痉挛，且在每例患者中，胆管造影后手术终止。每一病例的随访胆管造影均显示壶腹通畅、造影剂自由流入十二指肠且无狭窄或结石。从这些数据得出的结论是，通过手术胆管镜检查可观察胆道的解剖结构和病理特征，并可评估Vater壶腹的通畅情况。
