[Secondary and residual choledocholithiasis. Our experience]

Area of Science:

• Gastroenterology
• Surgical Oncology
• Hepatobiliary Surgery

Background:

• Choledocholithiasis, the presence of stones in the common bile duct, is a significant complication of biliary tract lithiasis.
• Understanding the incidence, presentation, and management of choledocholithiasis is crucial for improving patient outcomes.

Purpose of the Study:

• To retrospectively analyze the incidence, clinical presentation, surgical management, and outcomes of choledocholithiasis in patients undergoing biliary tract surgery.
• To identify risk factors and common complications associated with choledocholithiasis.

Main Methods:

• Retrospective review of 780 patients who underwent biliary tract surgery for lithiasis between 1973 and 1984.
• Data collection included patient demographics, symptoms, diagnostic findings, surgical procedures, and postoperative complications.

Main Results:

• Secondary choledocholithiasis was observed in 14.1% of patients; residual choledocholithiasis in 1.8%.
• The highest incidence was in the 60-70 year age group, with a 2:1 female-to-male ratio. Biliary colic (99%) and jaundice (65%) were predominant symptoms.
• Choledochotomy with calculi extraction and Kehr tube placement was the most frequent procedure (50%). Postoperative morbidity was 22.5% and mortality was 3.2%, with infectious complications being most common.

Conclusions:

• Choledocholithiasis remains a significant concern in biliary tract surgery, particularly in older patients and women.
• Prompt diagnosis and appropriate surgical intervention are essential, with choledochotomy being a common approach.
• Minimizing postoperative infectious complications is critical for reducing morbidity and mortality.