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Related Experiment Video

Updated: Feb 15, 2026

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Biliary Bypass with Laparoscopic Choledochoduodenostomy.

Joshua K Kays1, Leonidas G Koniaris2, Daniel P Milgrom2

  • 1Department of Surgery, Indiana University School of Medicine, 545 Barnhill Drive, Emerson Hall 202, Indianapolis, IN, 46202, USA. joshkays@iupui.edu.

Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract
|January 18, 2018
PubMed
Summary

Laparoscopic choledochoduodenostomy (LCDD) offers a safe and effective surgical bypass for benign biliary diseases. This technique, involving common bile duct transection, demonstrated good patient tolerance and minimal complications in a recent study.

Keywords:
Biliary bypassCholedochoduodenostomyLaparoscopy

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Area of Science:

  • Gastroenterology
  • Hepatobiliary Surgery
  • Minimally Invasive Surgery

Background:

  • Benign biliary diseases often require surgical intervention when endoscopic or percutaneous methods are not feasible.
  • Laparoscopic choledochoduodenostomy (LCDD) is a viable surgical option in such cases.
  • Effective biliary bypass techniques are crucial for managing complex biliary pathology.

Purpose of the Study:

  • To describe a specific technique for laparoscopic choledochoduodenostomy (LCDD) involving common bile duct transection and end-to-side anastomosis.
  • To evaluate the safety and efficacy of this LCDD technique in patients with benign biliary diseases.
  • To identify key procedural details and potential pitfalls associated with LCDD.

Main Methods:

  • The study details a laparoscopic procedure including common bile duct isolation and transection, Kocher maneuver for duodenal mobilization, and end-to-side biliary-enteric anastomosis.
  • A retrospective review of 18 patients who underwent LCDD over a 5-year period was conducted.
  • Data collected included indications for surgery, operative outcomes, complications, and length of hospital stay.

Main Results:

  • LCDD was performed for intractable abdominal pain (10 patients) and choledocholithiasis (8 patients).
  • 83% of patients experienced no complications; one intra-abdominal abscess and two anastomotic strictures were noted.
  • The median length of stay was 4 days with minimal blood loss, indicating good tolerability.

Conclusions:

  • Laparoscopic choledochoduodenostomy with common bile duct transection and end-to-side biliary-enteric anastomosis is a safe and effective surgical bypass.
  • This technique provides a valuable treatment option for benign biliary diseases when less invasive methods fail.
  • Careful attention to procedural details is important to minimize potential complications like anastomotic strictures.