An operative choledochoscopy using the flexible choledochoscope.

In a prospective study, the value of operative choledochoscopy as a completion procedure after standard instrumental exploration of the common bile duct is evaluated. The technique of examination using the flexible scope is described. Operative choledochoscopy was performed upon 320 patients. Retained stones of the biliary tract missed by exploration were detected in 23 patients (7.1 per cent). Stones retained in spite of endoscopic examination were found in five (1.6 per cent) of the patients. The comparison of the personal experience (158 patients) with the experience of other surgeons and registrars performing the biliary tract operations on their own at our institutions (178 patients) allows a conclusion that, if the technique of choledochoscopy is well standardized and correctly learned, no difference in results achieved is to be expect. Operative choledochoscopy is a reliable method of examination supporting valuable diagnostic information, contributing to the operative decision making and reducing efficiently the incidence of retained biliary tract stones.