Abstract
Advances in choledochoscopy technology lead to an improvement in the diagnosis and treatment of hepatopancreatobiliary diseases. The aim of this study is to reveal the role of choledochoscopy in hepatopancreatobiliary pathologies. Choledochoscopy was used under general anesthesia in operation rooms. Flexible choledochoscope inserted via a vertical choledochotomy line, which was closed by primary closure, T-tube application, or choledochoduodenal anastomosis. Olympus CHF T 20 flexible choledochoscope and related endoscopic instruments were used for the procedures. The records were evaluated retrospectively. This study presents the findings of 235 intraoperative choledochoscopy procedures. The most common indications were suspected common bile duct stone in 96 patients (40.9%), serum cholestatic enzyme increase without jaundice in 52 (22.1%), obstructive jaundice and/or serum bilirubin increase in 46 (19.6%), and presence of dilated choledoch in 42 (17.9%). Additional endoscopic diagnostic and/or therapeutic procedures were performed 156 times in 125 patients (53.2%), and endoscopic biliary stone removal was the most used procedure (87 patients, 37.0%). The mean choledochoscopy duration was 8.5 minutes (range: 5-25 minutes). Choledochoscopy confirmed preliminary diagnosis in 117 patients (49.8%), while different data were elicited in 68 (28.9%), and normal findings were found in 50 (21.3%). In this series, no choledochoscopy-related mortality was seen, and some complications occurred in 4 patients (1.7%). Intraoperative flexible choledochoscopy is a proper technique in the diagnosis and treatment of hepatopancreatobiliary disorders.
Highlights
Many medical records determined that biliary stones were known and treated from the ancient times [1, 2]
This study presents the findings of 235 intraoperative choledochoscopy procedures
No choledochoscopy-related mortality was seen, and some complications occurred in 4 patients (1.7%)
Summary
Many medical records determined that biliary stones were known and treated from the ancient times [1, 2]. The revolution of the diagnosis and treatment in medical sciences was experienced with the application of fiberoptic technology since 1960’s [3]. Technology was started to scan gastrointestinal system, and than choledoch, one of the narrowest channels of the body, was visualised by the endoscopes. After the first experience of Kawai et al [4] in. Disci et al Choledochoscopy with choledochoscope, improvements in the shapes, optic system and mobilisation capability of the endoscopes made the choledochoscopy as valuable method in the diagnosis and treatment of hepatopancreatobiliary system diseases [5,6,7,8].
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