Publication: Choledochoduodenostomy: a study of 28 consecutive cases
Date
2004
Authors
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Journal ISSN
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Publisher
Kathmandu University
Abstract
Objectives: Choledocholithiasis is a common problem in South Asia. Proper drainage of the CBD is essential to
reduce the chance of residual stones and recurrent stones. The paper highlights the surgical management of
choledocholithiasis by side to side choledochoduodenostomy and the post surgical complications.
Method: 28 cases of choledocholithiasis treated by choledochoduodenostomy between March 1995 and June 2003
were studied. After pre operative diagnosis and per operative confirmation, side to side choledochoduodenostomy
was done. It is a triangulated anastomosis between the bile duct and post bulbar duodenum using single layer
interrupted suture. The cases were meticulously followed up for detecting complications
Results: 79% of the patients who underwent choledochoduodenostomy were female and majority (43%) belonged to
the 51 to 60 age group. All the patients selected for CDD had a dilated common duct of at least 1.5 cm diameter and
71% of them had multiple stones. 79% were asymptomatic during the follow up, two patients developed wound
infection. 18% developed alkaline reflux gastritis and only one patient suffered from recurrent cholangitis because of
inadequate stoma size. No case of “sump syndrome” was observed in this series.
Conclusion: Side to side CDD is an easy, effective and definitive method of decompression, especially when there
are multiple stones in a dilated CBD.
Keywords: Choledochoduodenostomy