[A new indication for transcutaneous cholangioscopy].
The main indication for transcutaneous cholangioscopy through a channel of percutaneous transhepatic drainage are choledocholithiasis, hepatolithiasis and non-malignant or malignant stenosis of the bile ducts. In our department we were able to treat thus repeatedly also complete severing of the biliary pathways.
Twelve patients with complete severing of the right hepatic ducts (4x) or common bile duct (8x) after cholecystectomy could not be operated on account of great surgical risk or adhesions after operation. On account of cholangitis they had percutaneous transhepatic drainage. After three weeks transcutaneous cholangioscopy was performed and recanalization by means of a needle-shaped knife. The operation was terminated by introduction of a metal prosthesis Palmaz.


RESULTS
The method was successful in all patients, there were no complications associated with the procedure.


CONCLUSIONS
Transcutaneous cholangioscopy and recanalization of complete severing of the biliary pathways is a new safe method. It is indicated in patients with increased surgical risk. For restoration of the continuity of the bile ducts a metal prosthesis Palmaz is inserted. Short-term results of treatment are satisfactors, long-term results call for a longer follow up.
Chirurgická klinika Fakultní nemocnice, Ostrava Poruba.
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Cernoch
D000328:Adult; D000368:Aged; D002763:Cholecystectomy / Q000009:adverse effects; D003135:Common Bile Duct / Q000293:injuries / Q000601:surgery*; D016145:Endoscopy, Digestive System / Q000379:methods; D005260:Female; D006500:Hepatic Duct, Common / Q000293:injuries / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011677:Punctures