title: Choledochoscopy in management of retained biliary stones and recurrent lesions.
abstract: Postoperative choledochofiberscopy was performed in 188 patients with retained biliary stones and recurrent lesions. The following entrances to the biliary tract for choledochoscopy were used: the T-tube tract (129 patients), an afferent jejunal limb of a choledochojejunostomy (43), the jejunostomy tube tract of an efferent limb (12), an U-tube tract (2), and a ductal fistula after segmental liver resection (2). 380 choledochoscopic sessions were carried out, 2 sessions on the average for each patient. The overall success rate of stone removal was 90.5%. No mortality was related to this procedure. Eleven patients developed fever and chills after manipulations but all responded to antibiotics. Two patients had perforation of the T-tube tract during the removal of stones and were reoperated on for abdominal drainage. They recovered eventually. Stone extraction with a flexible choledochoscope is a proven procedure. For residual intrahepatic stones, however, a satisfactory entrance into the biliary tree should be provided for subsequent stone removals. We believe that the jejunostomy tube tract of an efferent limb of an afferent jejunal limb of a choledochojejunostomy is a useful entrance for choledochoscopy because it is permanent in meeting therapeutic demands.
authors.affiliation: Department of General Surgery, Xijing Hospital, Fourth Military Medical College, Xian.
authors.forename: Z N
authors.initials: ZN
authors.lastname: Chao
authors.forename: F Z
authors.initials: FZ
authors.lastname: Tian
authors.forename: D R
authors.initials: DR
authors.lastname: Huang
authors.forename: B Y
authors.initials: BY
authors.lastname: Zhang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001649:Bile Duct Diseases / Q000601:surgery; D001653:Bile Ducts, Intrahepatic; D002768:Choledochostomy; D002769:Cholelithiasis / Q000601:surgery*; D004724:Endoscopy / Q000379:methods; D006801:Humans; D008875:Middle Aged; D012086:Reoperation