Radiology, Vol 180, 355-361, Copyright © 1991 by Radiological Society of North America
Endoscopy as an adjuvant to biliary radiologic intervention
AC Venbrux, KV Robbins, SJ Savader, SE Mitchell, DM Widlus and FA Osterman Jr
Russell H. Morgan Department of Radiology and Radiologic Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21205-2191.
Twenty-two patients underwent 24 percutaneous biliary procedures guided
with choledochoscopy, an adjunctive percutaneous biliary technique. All but
four procedures were performed through established percutaneous tracts; the
others, through tracts less than 4 weeks old. The procedures were done for
the following reasons: removal of calculi (n = 15), electrohydraulic
lithotripsy (n = 1), biliary duct biopsies (n = 8), cauterization of a
bleeding tract (n = 1), and evaluation of biliary-enteric anastomoses (n =
11). The only complication was one case of severe nausea after
choledochoscopy. This patient required overnight hospitalization and
medical treatment. All procedures were technically successful, except one
case in which the tract was undersized. All patients received intravenously
administered antibiotics before and after the procedure. It is concluded
that choledochoscopy is a safe, atraumatic, and well-tolerated method of
evaluating and treating biliary disease and that it markedly reduces
radiation exposure. It can be performed rapidly with minimal sedation on an
in- or outpatient basis.
