[10 years' experience with the use of endoscopy in the intraoperative diagnosis of extrahepatic biliary tract diseases]

In the last ten years 375 patients were operated on biliary tract examined with intraoperative choledochoscopy. Sensitivity of choledochoscopy in our investigation was 72% and negative predictive value was 85% while specificity and positive predictive value for flexible choledochoscopy was 100%. There were no false positive results. After the instrumental exploration of the common bile duct, unsuspected stones were found in 9.19% of patients recorded with choledochoscopy and 3.44% of retained stones confirmed by postoperative cholangiography. Choledochoscopy was successful in determination of the level of obstruction by tumors in all patients (100%), but of limited value in determination of tumor extension through the bile duct wall in 66.66% of patients. Interventional procedures through the work channel of the instrument showed little success. Extraction of impacted stones was recorded in one patient (3.70%) while the biopsies were completely unsuccessful. We recommend choledochoscopy for each patient with open common bile duct, especially with proved multiple common bile duct stones.