Forceps biopsy of the bile duct under choledochoscopic control.

Forceps biopsy of the distal part of the common bile duct was performed in 27 patients with cholelithiasis, under choledochoscopic guidance during surgery. Significant choledochitis was diagnosed in 72 per cent of the patients, including two with carcinoma of the head of the pancreas. Two patients with carcinoma of the head of the pancreas underwent biopsy in an attempt to obtain evidence of neoplasm. Furthermore, one patient suspected of carcinoma of the left hepatic duct tributaries received the same treatment and the malignancy was confirmed. No complications occurred. The prime indication for biopsy is to prove the presence of malignancy at this region and to provide an index for the management of cholangitis combined with choledocholitiasis.