Choledochoduodenostomy: simple side-to-side anastomosis

Choledochoduodenostomy, using a simple side-to-side anastomosis technique, was performed in a 74-year-old woman with common bile duct stones. She had chronic heart failure and chronic obstructive lung disease. The choledochoduodenostomy was performed with a cholecystectomy. A 2-cm-longitudinal incision was made in the common bile duct, and an adjacent longitudinal incision was made in the first portion of the duodenum. The first sutures to be placed were the two corner sutures of the posterior anastomotic wall. Then the two sides were sutured, one from the hepatic side corner of the common duct to the anal side corner of the duodenum, and the other from the duodenal side corner of the common duct to the oral side corner of the duodenum. This anastomosis was performed with one layer of interrupted 4-0 adsorbable sutures. The anterior wall of the anastomosis was constructed in a similar manner. The patient recovered uneventfully, and had no complaints of abdominal pain or fever. This procedure, our original method, is technically simple and safe, and results in minimal tension of the anastomosis.