[Traditional surgical treatment of choledocholithiasis. An analysis of a 10-year material 1980-89]

During 1980-89, 224 patients, 129 women and 95 men, median age 72 years (18-96 years), were treated for common bile duct stones. 26 of the patients had remote cholecystectomy. 67 patients had additional acute cholecystitis, 37 acute cholangitis and 25 acute pancreatitis. 173 patients underwent a traditional open operation, 37 endoscopic papillotomy (EPT) and 14 were treated conservatively. No deaths occurred after elective operations in 52 patients, and one death occurred after early planned operation in 95 patients. Emergency operations and delayed operations for acute disease were encumbered with a lethality of 12%. During the last two years of the study, old septic patients were treated with papillotomy, and there was no mortality among the last 39 patients. The study shows that non-septic patients with common bile duct stones can be safely treated by open operation. Old patients with severe complicated gall stone disease should be treated by endoscopic papillotomy at an early stage.