Recent acquisitions in surgery of the extrahepatic biliary passages

Recent advances in the diagnosis and surgical management of cases involving the extrahepatic bile ducts are illustrated. Particular stress is laid on the universally recognised importance of preoperative cholangiography, the usefulness of the flexible choledochoscope, and the employment of cold light to visualise calculi undetected by cholangiography. The scope of and indications for direct surgery on the papilla, derivative operations, and reconstruction of the duct are discussed. Lastly, reference is made to the use of endoscopic sphincterotomy, and the suitability of continuous perfusion of the ducts in the destruction of calculi.