CZECH MEDICAL ASSOCIATION J. Ev. PURKYNĚ | |
Journals - Article | |
Česky / Czech version | Rozhl. Chir., 2007, roč. 86, č. 4, s. 180–183. |
Our Experience with Peroperative Choledochoscopy Schwarz, J., Šimša, J., Pazdírek F. Chirurgická klinika UK 2. LF a FN Praha-Motol, přednosta: prof. MUDr. J. Hoch, CSc. |
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Summary: Introduction: Choledocholithiasis is nowadays managed endoscopicaly in the majority of patients. Open surgery with CBD exploration
remains important, when endoscopy failed. The completeness of stones' extraction may be confirmed with choledochoscopy.
Method: The retrospective analysis of patients operated on choledocholithiasis within the period of seven years was performed. Two
groups of patients were studied. First group was managed by choledocholithotomy followed by choledochoscopy. Second group underwent
exploration of the common bile duct without choledochoscopy. Frequency of the residual stones in both groups was studied. Statistical
evaluation was done using α2 test. The value of p < 0.05 was settled as statistically significant.
Results: In the study period of seven years 46 patients were operated on CBD stones. Choledocholithotomy followed by intra-operative
choledochoscopy was performed in 21 patients. No remnant stones were recorded in this group. Exploration of the CBD with stone
extraction without choledochoscopy was done in 25 patients. In this group residual stones occurred in 3 patients. The result was not statistically
significant, p = 0.10.
Conclusions: According to our experience and literature, intra-operative choledochoscopy can reduce frequency of the residual CBD stones.
Peroperative choledochoscopy can thus be recommended as an accessory procedure to CBD exploration to prevent stones oversight.
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