Indications and results of choledochoduodenostomy in benign biliary tract diseases

During a 12-year period ending December 1987, 17,200 operations for biliary tract disease were performed at the Dept. of Surgery of the University of Chile. Choledochoduodenostomy was performed in 140 of these patients operated upon for benign biliary tract and/or gallbladder diseases. The indications for this procedure were choledocholithiasis, stenosis of the sphincter of Oddi, compression of the extrahepatic biliary duct, stenosis of the distal biliary duct and duodenal diverticula. The postoperative course was uncomplicated in 126 patients (90%). The mortality rate was 4.2%. Although the mortality was somewhat greater in patients with acute cholangitis, the difference was not significant, and no significant relation could be established with other factors that might affect mortality. Choledocholithiasis is the main cause of benign obstruction of the biliary tract in Chile. This is also the most frequent indication for external choledochoduodenostomy and is a promising method even in the presence of an infection of the biliary duct.