MANAGEMENT OF CHOLEDOCHOLITHIASIS WITH SPECIAL REFERENCE TO USE OF CHOLEDOCHOSCOPY

Prof. Dr. C. Sugumar, Dr. Chitrakala Sugumar

Abstract


AIM: To evaluate the role of operative flexible choledochoscopy after choledocholithothomy /transcystic choledochoscopy in reducing the
incidence of retained stones in the common bile duct.
MATERIALS AND METHODS: The patients who had their common bile duct explored for proven common bile duct stones during three years
period from 2013 to 2016 were reviewed prospectively at Departments of Surgical Gastroenterology & Pathology, Government Kilpauk Medical
College Hospital, Chennai. During this period, forty four patients with confirmed common bile duct stone with or without gallstones were chosen.
Initial decision to explore the common bile duct was made by ultrasound in 20 patients (45%), ERCP in 8 patients (18%), CT in 10 patients (23%),
MRCP in 6 patients (14%)
RESULTS: In this prospective analysis of forty four patients, transcystic choledochoscopy was done in 4 patients (9.09%) and
transcholedochotomy with choledochoscopy in 40 patients (90.91%). The failure rate of choledochoscopy accounted to just 2.27%.
CONCLUSION: The incidence of retained stone was comparatively lower in the study and it was comparable to international standards.


Keywords


Choledocholithiasis, Choledochoscopy, CBD, MRCP, ERCP

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