Long-term results of choledochoduodenostomy in benign biliary obstruction
Ajaz A Malik1, Shiraz A Rather, Shams Ul Bari
1Ajaz A Malik, Shiraz A Rather, Khurshid Alam Wani, Department of Surgery, Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Kashmir 190006, India.
Aim:
To determine the long-term results of choledochodudenostomy in patients with benign billiary obstruction.
Methods:
This prospective study was conducted at Sheri Kashmir Institute of Medical Sciences Srinagar Kashmir, India over a period of 10 years from January 1997 to December 2007. The total number of patients who underwent choledochoduodenostomy during this period was 270. On the basis of etiology of biliary tract obstruction, patients were divided into a calculus group, an oriental cholangiohepatitis group, a benign biliary stricture group and others. Patients were followed for a variable period of 13 mo to 15 years.
Results:
Choledochoduodenostomy (CDD) with duo-denotomy was performend in four patients. CDD with removal of T- tube, CDD with left hepatic lobectomy and CDD with removal of intra biliary ruptured hydatid was performed in three patients each. In the remaining patients only CDD was performed. Immediate post operative complications were seen in 63 (23%) patients, while long-term complications were seen in 28 (11%) patients, which were statistically significant. Three patients died during hospitalization while four patients died in the late post-operative period.
Conclusion:
Our conclusion is that CDD is safe and produces good long term results when a permanent biliary drainage procedure is required.