Since endoscopic examination of the biliary tract is of paramount importance, it is desirable to improve and accomplish the fibercholangioscope. The flexible choledochoscope developed by Shore et al, has neither angle deflector nor forceps device, and is unsatisfactory both to diagnosis and treatment. Therefore, we use Machida's fiberbronchoscope (FBS) as a new approach to the examination of the biliary tract. It is 5mm in diameter and has an angle deflector and built-in forceps device. Its forceps channel is used for the bile-drainage and the circulation of the normal saline. We can remove intra-ductal stones easily with our newly devised stone-forceps through the biopsy channel. Though our bile-drainage unit is not perfect, it is better than any other one ever reported. So far, for draining bile, we have employed washing and circulation units, both of which are, however, a little complicated to operate. Then, we applied Olympus-made fiberesophagoscope (EF-PA) to the examination of the biliary tract. It is 7.2mm in diameter and has angle deflector. forceps device, and built-in air-and water-supplying system. The automatic one touch button system of supplying air and water, and of suction makes the manipulation simple and easy, keeps the operative field neat and clean and distends the wall moderately so that we can observe the biliary tract easily. To date, we have performed fibercholangioscopy and in a series of 90 cases. among which 13 cases with Shore's flexible choledochoscope, 40 with FBS, and 37 with EF-PA. Here in this report, we discuss the conditions of ideal fibercholangioscope and introduce our newly devised fibercholangioscope, to which the advantages of the various existing fiberscopes are applied.

View full abstract

Spontaneus Internal Bilary Fistula is regarded as a comparative rare disease in Japan. This is scant of remarkable subjective sympton and so the x-rays examination is a clue to diagnose. The case that we diagnosed it as “Biliary-Duodenal Fistula.” from x-ray examination in which we performed the Duodenal-Fiberscope to the duodenal before operation We report on the experence with the case that insert a camera into the bile through a fester eavity and observed the inner walls.

View full abstract