Choledochoduodenostomy: a study of 28 consecutive cases

Choledocholithiasis is a common problem in South Asia. Proper drainage of the CBD is essential to reduce the chance of residual stones and recurrent stones. The paper highlights the surgical management of choledocholithiasis by side to side choledochoduodenostomy and the post surgical complications.

28 cases of choledocholithiasis treated by choledochoduodenostomy between March 1995 and June 2003 were studied. After pre operative diagnosis and per operative confirmation, side to side choledochoduodenostomy was done. It is a triangulated anastomosis between the bile duct and post bulbar duodenum using single layer interrupted suture. The cases were meticulously followed up for detecting complications

79% of the patients who underwent choledochoduodenostomy were female and majority (43%) belonged to the 51 to 60 age group. All the patients selected for CDD had a dilated common duct of at least 1.5 cm diameter and 71% of them had multiple stones. 79% were asymptomatic during the follow up, two patients developed wound infection. 18% developed alkaline reflux gastritis and only one patient suffered from recurrent cholangitis because of inadequate stoma size. No case of sump syndrome was observed in this series.

Side to side CDD is an easy, effective and definitive method of decompression, especially when there are multiple stones in a dilated CBD.