[Long-term results of emergency surgery on the extrahepatic bile ducts]

During urgent and emergent operations for acute cholecystitis choledochotomy was fulfilled in 255 patients. The opening of ductus choledochus was accomplished by external drainage in 179 patients, biliodigestive anastomosis in 61 patients and suture of the bile duct in 15 patients. In the postoperative period 37 patients (14.5%) died (6 of them after biliodigestive anastomosis, the rest--after external drainage). Remote results were studied in 171 (78.4%) patients of 218. Of 171 patients 21 died of various causes, two of them--of bile duct diseases. Good remote results were obtained in 87 (58%) of 150 patients examined. Satisfactory results were observed in 41 (27.3%) patients and 22 patients (14.7%) had bad results. Bad results were mainly observed in patients after choledochostomy (20 patients). The data obtained enabled the authors to emphasize that stable recovery was observed in the people who had a careful revision of the main ducts with use of contrast cholangiography and rationaly accomplished choledochotomy. The authors restrict indications for choledochostomy. The approximation suture of ductus choledochus and choledochoduodenostomy in urgent operations should be combined with the disloading microdrainage through the stump of the bile duct.