[Choledocholithiasis: risk factors and their significance for pre- and intraoperative diagnosis]

In 19% of the cholecystectomies done for acute cholecystitis, cholangitis and/or jaundice, an operative cholangiogram could not be obtained, usually because of considerable local inflammatory changes. This was the case in only 1.7% of the operations for uncomplicated cholelithiasis. Surprisingly high was the 31% rate of choledocholithiasis among the patients with complicated cholelithiasis, when compared to the 8% rate for operations in the complication-free interval. If a cholangiogram could not be obtained, exploration of the choledochal duct also was renounced. So patients with residual choledochal stones had to be expected, and in fact became symptomatically within the five years of follow-up.