[The current aspects of treating residual choledocholithiasis]

Taking into consideration the seriousness of the problem residual calculosis of the common bile duct, the authors analyse the noninvasive methods of treatment during the past 20-30 years. Available data in the literature are adduced pointing to the importance of endoscopic papillotomy and extraction of the calculi. Indications and contraindications for performing this procedure are defined. The different methods of treatment are evaluated on the basis of a follow up of three patients with residual calculosis of the common bile duct, treated by noninvasive method and the experience of treatment of nine patients with this disease for a period of nine years at the Department of Propedeutics of Surgical Diseases, Medical Academy in Sofia, on the one hand, and the experience with 984 patients in whom endoscopic papillotomy has been performed at the Workers Hospital "Dr. R. Angelov" in Sofia, on the other. Preference is given to endoscopic papillotomy with extraction of the calculi in residual common bile duct calculosis over operative treatment, with observance of definite indications. Excellent results of this therapeutic approach are reported: total percentage of early complications 1.52, late complications 1, ineffectiveness of the method 0.4 and case fatality rate 0.6. Another advantage is the limited contraindications and possibility for operative correction.