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Related Experiment Videos

Choledochoduodenostomy: a study of 28 consecutive cases.

B S Gupta1

  • 1Department of Surgery, College of Medical Sciences, Nepal. bodhisatwasengupta@rediffmail.com

Kathmandu University Medical Journal (KUMJ)
|January 10, 2006
PubMed
Summary

Side-to-side choledochoduodenostomy effectively manages common bile duct stones. This surgical approach offers definitive decompression, particularly for patients with multiple stones in a dilated bile duct, with a low complication rate.

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Area of Science:

  • Gastroenterology
  • Surgical Gastroenterology
  • Hepatobiliary Surgery

Background:

  • Choledocholithiasis, or common bile duct stones, is prevalent in South Asia.
  • Adequate bile duct drainage is crucial to prevent residual and recurrent stones.
  • Surgical management options for choledocholithiasis require careful consideration.

Purpose of the Study:

  • To evaluate the efficacy and safety of side-to-side choledochoduodenostomy for treating choledocholithiasis.
  • To highlight surgical management strategies and analyze post-operative complications.

Main Methods:

  • A retrospective study of 28 patients with choledocholithiasis treated between 1995 and 2003.
  • Diagnosis confirmed pre-operatively and intra-operatively.
  • Side-to-side choledochoduodenostomy performed using a single-layer interrupted suture technique.

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Main Results:

  • The majority of patients (79%) were female, with 43% aged 51-60.
  • All patients had a dilated common bile duct (≥1.5 cm diameter), and 71% had multiple stones.
  • Post-operative follow-up showed 79% asymptomatic, with low complication rates including wound infection (2 patients) and alkaline reflux gastritis (18%). One patient had recurrent cholangitis due to inadequate stoma size. No sump syndrome was observed.

Conclusions:

  • Side-to-side choledochoduodenostomy is an effective and definitive surgical procedure for common bile duct stone management.
  • The technique provides excellent decompression, especially in cases of multiple stones within a dilated common bile duct.
  • This method demonstrates a favorable safety profile with manageable post-operative complications.