Objective: To investigate the feasibility and implementation value of fibercholangioscopic bile duct exploration guided by laparoscopy.
Methods: All patients who had indications for bile duct exploration underwent laparoscopic common bile duct (CBD) exploration.After CBD incision was made laparoscopically, the cholangioscope was introduced into CBD for examination and treatment. Placement of T-tube or primary suturing of CBD was applied after exploration.
Results: Among the 152 patients who underwent CBD exploration, 141 patients had extrahepatic bile duct stone(s) which were all successfully extracted; and 11 patients were without bile duct stones (negative exploration). The time spent on cholangioscopic exploration and, or stone extraction was about 8 to 35 min (average 15 min). All 152 cases were operated successfully without conversion to open surgery. The CBD incision was sutured endoscopically after exploration in 42 patients, and the other 110 patients had T-tube drainge. The T-tubes were removed after a T-tube cholangiogram, done 3-4 weeks posoperatively, showed no residual stones. Two cases of bile leakage were discovered; however, there was no biliary stricture or residual stones in this series. Postoperative hospital stay of the patients was  4 to 7 days (average5 days). One hundred and fifty-two patients were followed up for 1 to 17 months (average 8 months)  with B-mode ultrasonography or MRCP examination,and no biliary tract stricture or residual stone was found in these patients.
Conclusions: Fibercholangioscopic bile duct exploration guided by laparoscopy is safe and reliable. Mini-trauma is more effective if primary suturing of the CBD can be done after the bile duct stones are totally extracted.