[Cholangioscopy after successful treatment of complicated choledocholithiasis. Is stone free really stone free?].
OBJECTIVE
After successful percutaneous or endoscopic therapy of complicated choledocholithiasis (requiring more than one therapeutic intervention or lithotripsy), radiological visualization of the bile duct is the standard to determine if any stone fragments are left. It is unknown how often stone fragments, which might be the cause for another period of symptomatic choledocholithiasis, are missed.


METHODS
We performed cholangioscopy in 31 consecutive patients (age 42 - 85; 14 male, 17 female) with complicated choledocholithiasis after successful therapy when there were no stone fragments left radiographically.


RESULTS
Cholangioscopy revealed retained stone fragments in four female patients. Two of these had a benign stricture of the common bile duct.


CONCLUSIONS
Cholangioscopy after successful endoscopic or percutaneous therapy of complicated choledocholithiasis seems to be useful, because in bile ducts radiographically free of stones, cholangioscopy detects stone fragments in some patients. Further studies are needed to demonstrate if cholangioscopy can reduce the rate of symptomatic relapse after treatment of complicated choledocholithiasis.
Weickert
U
U
Medizinische Klinik C, Klinikum der Stadt Ludwigshafen gGmbH. MedCLu@t-online.de
Jakobs
R
R
Hahne
M
M
Eickhoff
A
A
Schilling
D
D
Riemann
J F
JF
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001652:Bile Ducts / Q000473:pathology*; D002763:Cholecystectomy; D003251:Constriction, Pathologic / Q000628:therapy; D016145:Endoscopy, Digestive System / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000150:complications / Q000473:pathology / Q000628:therapy*; D006801:Humans; D008096:Lithotripsy; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D055502:Secondary Prevention; D013270:Stomach / Q000601:surgery; D016896:Treatment Outcome