Use of fiberoptic choledochoscope in common bile duct and intrahepatic duct exploration.

This report summarizes our experience with 339 consecutive flexible fiberoptic choledochoscopic examinations performed in the course of 598 common bile duct explorations for biliary tract stones. Routine choledochoscopy added 5 to 10 minutes to the operation and caused no complications. In 81 of the patients, additional stones were discovered with choledochofiberscopy after completion of routine bile duct exploration. Postoperative cholangiography demonstrated a retained stone in 57 patients (two in the common bile duct and 55 in the intrahepatic ducts). Forty-two patients with stones retained in the intrahepatic ducts were diagnosed during operation with the fiberoptic choledochoscope, but those stones were very difficult for us to remove. The accuracy of postexploratory choledochoscopy in diagnosis of stones in the common bile duct and intrahepatic ducts was 99.0% and 90.5%, respectively. Choledochofiberscopy is useful in exploration of the common bile duct and a safe procedure in the diagnosis of biliary tract stones during operation.