Choledochoduodenostomy for choledocholithiasis. Indications and functional results

Area of Science:

• Gastroenterology
• Surgical Procedures
• Biliary Tract Interventions

Background:

• Choledochoduodenostomy is a discussed procedure for common bile duct stones.
• Endoscopic sphincterotomy's success prompts re-evaluation of adjunct procedures like choledochoduodenostomy.
• Indications and value of choledochoduodenostomy require further examination.

Purpose of the Study:

• To evaluate the efficacy and safety of choledochoduodenostomy as an adjunct to choledocholithotomy.
• To assess outcomes in elderly, high-risk patients undergoing this procedure.
• To determine its role in preventing retained or recurrent common bile duct stones.

Main Methods:

• Retrospective analysis of 20 patients (mean age 73) undergoing choledocholithotomy and choledochoduodenostomy.
• Procedures performed as primary, secondary, or tertiary operations.
• Analysis of patient demographics, stone characteristics, and postoperative outcomes.

Main Results:

• No postoperative mortality; one early complication (pneumonia).
• 18 of 20 patients were symptom-free with normal liver function and open anastomoses.
• Two patients experienced recurrent cholangitis due to stricture or retained stones.

Conclusions:

• Choledochoduodenostomy is technically simple with low morbidity, even in elderly, high-risk patients.
• It is a safe and effective method for preventing retained or recurrent common bile duct stones.
• The procedure demonstrates significant long-term benefits for selected patients.