[Recurrent and residual choledocholithiasis]

Many years' experience in treatment of 617 patients with choledocholithiasis (ChDL) served the basis for analysis of the causes of residual (72.4%) and recurrent (21.4%) lithiasis of bile ducts in patients with postcholecystectomy syndrome. In 6.2% of cases identification of the type of ChDL was not a success. Recommendations in prophylaxis of recurrent as well as residual lithiasis are given. In 78.5% of patients with residual stones after primary operation choledochotomy with removal of the stones was made with cholecystectomy but as was evidenced later not all the stones were removed. Data on diagnostic value of clinical symptoms and US examinations for revealing ChDL are presented. ChDL without jaundice was detected in 47.4% of patients. Current diagnostic facilities in primary choledocholithiasis before the operation and intraoperative are discussed. After choledochotomy, if there are no contraindications, it is recommended to finish the operation by external drainage of bile ducts with the use of T-shaped drainage tube. If residual ChDL is detected, it would be reliably eliminated without surgery.