[Surgical bile duct revision--indications, technique, results]

Nonsurgical methods compete with common bile duct exploration (CBDE) in the treatment of choledocholithiasis. Following CBDE residual duct stones are found in 6% of cases and the mortality is 2%. In our patients (n = 373) the numbers were 5.4% and 1.6% respectively. The lowest rates of residual duct stones were seen following a combination of intraoperative cholangiography and choledochoscopy. CBDE is indicated when cholecholithiasis is discovered intraoperatively, in low-risk patients with gallbladder and bile duct stones, after unsuccessful endoscopic procedures, in cases, of other pathologic findings of the bile duct requiring surgery or even in younger patients after prior cholecystectomy.