Operative Cholangiography and Overlooked Stones

To the Editor.–In the June 1978 issue, Corlette and colleagues (113:729, 1978) described the use of operative cholangiography and discussed ways of producing a lower incidence of over-looked biliary calculi. It seems surprising to me in this day and age that neither the authors nor Griffen, in his editorial comment, mentioned the use of choledochoscopy. Choledochoscopy along with completion operative cholangiography can markedly diminish the incidence of retained common duct stones. Finnis¹ has described the use of operative choledochoscopy to obviate completion cholangiography. In one general surgical private practice, the ability to use an operative choledochoscope has resulted in several instances in which otherwise retained common duct stones have been discovered. It would seem to me in light of current and improving technology that an operative choledochoscopy is a necessity for a complete exploration of the common bile duct.