title: Biliary cutaneous stent insertion via T-tube tract by choledochoscopy.
abstract: BACKGROUND
  Postoperative biliary ductal dilation and stent insertion are mandatory for managing complicated residual hepatolithiasis with intrahepatic strictures. Usually this procedure is performed under fluoroscopic guidance. Choledochoscopic examination is a routine procedure for residual hepatolithiasis. This is the first report of choledochoscopic biliary cutaneous stent insertion.
  
  
  METHODS
  Fifty-three patients underwent biliary cutaneous stent insertion under postoperative choledochoscopic guidance. Of the 53 patients, 35 had strictured intrahepatic ducts, 6 a stenotic hilum, 9 a tortuous fistula tract and 3 a choledochoduodenocutaneous fistula.
  
  
  RESULTS
  A total of 120 procedures have been performed in the 53 patients. Two thirds necessitated a repeated procedure. No major complication was found except 2 patients experienced mild abdominal pain after the procedure. Neither fluoroscopy nor contrast medium was used.
  
  
  CONCLUSIONS
  Choledochoscopic guidance is effective for postoperative biliary cutaneous stent insertion. It has the advantage of being technically easy and is relatively safe.
authors.affiliation: Department of Surgery, Chang Gung Memorial Hospital, Chang Gung University Medical College, Taipei, Taiwan.
authors.forename: M F
authors.initials: MF
authors.lastname: Chen
authors.forename: Y Y
authors.initials: YY
authors.lastname: Jan
mesh_terms: D001658:Biliary Fistula / Q000175:diagnosis / Q000601:surgery; D002763:Cholecystectomy; D002769:Cholelithiasis / Q000175:diagnosis / Q000601:surgery*; D002780:Cholestasis, Intrahepatic / Q000175:diagnosis / Q000601:surgery*; D003135:Common Bile Duct; D004106:Dilatation / Q000295:instrumentation; D020776:Endoscopes, Gastrointestinal; D005500:Follow-Up Studies; D042882:Gallstones / Q000175:diagnosis / Q000601:surgery; D006801:Humans; D012008:Recurrence; D012086:Reoperation; D015607:Stents