A scientific evaluation of operative choledochoscopy in acute cholangitis

A prospective study to determine the safety and effectiveness of choledochoscopy in acute cholangitis and acute suppurative cholangitis due to common bile duct stones was conducted on 70 patients. Common bile duct pressures determined on the first 20 patients showed that choledochoscopy was unlikely...

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Bibliographic Details
Published inAnnals of surgery Vol. 206; no. 2; pp. 142 - 147
Main Authors Lau, W Y, Chong, K K, Fan, S T, Chu, K W, Yip, W C, Poon, G P, Wong, K K
Format Journal Article
LanguageEnglish
Published Hagerstown, MD Lippincott 01.08.1987
Subjects
Acute Disease
Adult
Aged
Aged, 80 and over
Biological and medical sciences
Cholangitis - diagnosis
Cholangitis - physiopathology
Cholangitis - surgery
Common Bile Duct - physiopathology
Endoscopy
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Other diseases. Semiology
Postoperative Complications
Pressure
Prospective Studies
Risk
Sepsis - etiology
Human
Biliary tract
Cholangioscopy
Choledoch
Acute
Surgery
Cholangitis
Digestive diseases
Intraoperative
Endoscopy
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Summary:A prospective study to determine the safety and effectiveness of choledochoscopy in acute cholangitis and acute suppurative cholangitis due to common bile duct stones was conducted on 70 patients. Common bile duct pressures determined on the first 20 patients showed that choledochoscopy was unlikely to cause cholangiovenous reflux. Laboratory and clinical parameters revealed that choledochoscopy did not cause septicemia, worsen cholangitis, or provoke acute pancreatitis. There was no iatrogenic injury during choledochoscopy, and the choledochoscopic views were minimally affected by cholangitis. Choledochoscopy detected overlooked stones after conventional methods of exploration of common bile ducts in 14.3% of patients and it helped to remove impacted stones in 2.9% of patients. As a result, the incidence of retained stones after choledochoscopy was 1.4%. Time spent in choledochoscopy was short, and the total postoperative septic complication rate was only 10%. There was no operative mortality. It is concluded that choledochoscopy is safe and effective in cholangitis.
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ISSN:0003-4932
1528-1140
DOI:10.1097/00000658-198708000-00005