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Choledochoduodenostomy: influence of risk factors in post-operative morbidity
K V Ravindra1, R Kapoor, S S Sikora
1Department of Surgical Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
Background:
Choledochoduodenostomy is performed for a variety of lower common bile duct lesions.
Aims:
To analyse the influence of risk factors on the post-operative morbidity following choledochoduodenostomy.
Methods:
Relation of risk factors including age more than 60 years, medical Illness, hemoglobin less than 10 g/dL, albumin less than 3 g/dL, bilirubin more than 10m/dL, presence of cholangitis at admission (treated pre-operatively), use of pre-operative endoscopic sphincterotomy and common bile duct diameter at surgery were related to the occurrence of post-operative morbidity was studied using univariate analysis.
Results:
Fifty patients underwent choledochoduodenostomy. One patient (2%) died; major post-operative morbidity occurred in 12 patients (24%). Presence of cholangitis at admission was the only factor related (p = 0.00012) to the occurrence of post-operative morbidity. No long-term complications were encountered in 35 patients (70%) mean with followup period of 28 (range 8-60) months.
Conclusions:
Choledochoduodenostomy is a safe permanent drainage procedure for benign lower biliary obstruction.