Follow-up studies of surgical treatment for choledocholithiasis

The follow-up results of cholecystectomy and common duct exploration with T-tube drainage for 308 patients with common bile duct stones were studied. Nine patients evaluated as "poor" included seven with residual stones and two with recurrent stones.. Cholangiography at the time of follow-up manifested the evidence of a statistically significant reduction of the bile-duct diameter compared with the preoperative level in both cholesterol and calcium bilirubinate cases. The reduction was particularly conspicuous in the group with marked dilatation of the bile duct, regardless of the types of stone. Of the 134 patients with cholelithiasis who underwent reoperations in our Department, 75 (87%) belonged to residual, 11 (13%) to recurrent group. Of the 11 patients with recurrent stones, nine had obvious causes for stone recurrence such as bile-duct stenosis or stricture at the anastomotic site. These results suggest that without existence of evident stenosis at the papilla of Vater or in the lower bile duct, patients with choledocholithiasis, regardless of types of stone, could be curable effectively only by cholecystectomy and choledocholithotomy with T-tube drainage.