OPERATIVE CHOLEDOCHOSCOPY

We have reported the results of 121 examinations with the rigid choledochoscope performed by 13 different surgeons between 1969 and 1977. Pre‐exploratory choledochoscopy was performed in 48 patients with a diagnostic accuracy of 94 per cent. Post‐exploratory choledochoscopy was used in 73 patients to define whether the common bile duct had been adequately cleared of stones. Fifty‐one patients were correctly assessed as having a clear duct and unsuspected residual calculi were demonstrated by choledochoscopy in 13 patients. However, choledochoscopy failed to identify 9 patients with retained stones. The accuracy of post‐exploratory choledochoscopy alone was 87 per cent and the accuracy of post‐exploratory cholangiography was 82 per cent, but when choledochoscopy was combined with post‐exploratory cholangiography there were no errors. We conclude that the addition of choledochoscopy to conventional radiological techniques is likely to reduce the incidence of residual calculi after choledochotomy. Copyright © 1979 British Journal of Surgery Society Ltd.