[Choledochotomy and the methods for its performance]

The authors have made 390 operations on ductus choledochus. Indications for choledochotomy were choledocholithiasis, jaundice, cholangitis and others. The ideal choledochotomy was fulfilled in 7,1% of cases as a completion of diagnostic manipulations on the duct. The external drainage of ductus choledochus was performed in peritonitis, severe cholangitis and inflammatory alterations of the hepatoduodenal ligament and in weak senile patients (mortality--11,7%). Multiple stones and great dilatation of the duct (mortality--4,5%) were considered to serve indications for supraduodenal choledochoduodenostomy (38,7%). Papillotomy was made in fixed ampula stones, stenosis of Vater's papilla (18,2%). Lethality in such cases was twice as high as after choledochoduodenostomy (8,5%). The authors believe peritonitis and duodenostasis to be contraindications against the internal drainage of biliary ducts.