Choledochoduodenostomy: importance of common duct size and occurrence of cholangitis

Choledochoduodenostomy was performed in 68 patients. In these cases, we attempted to determine any correlation between the size of the common duct and subsequent cholangitis. Follow-up information was available in 64 (94%) of the cases, with a mean follow-up of three years. The most common indication for choledochoduodenostomy was choledocholiothiasis. Prior biliary surgery was used in 33 (48%) patients. Benign disease was present in 51 patients, and 17 patients had malignant neoplasms. The mean size of the common duct was 2.1 cm and the range was 1.0 to 4.0 cm. Only two patients (2.8%) experienced episodes of cholangitis after choledochoduodenostomy and both of these patients had a common duct that measured less than 1.6 cm at the time of anastomosis. Other procedures than choledochoduodenostomy should be considered when common duct size is less than 1.6 cm.