CHOLEDOCHODUODENOSTOMY FOR COMMON BILE-DUCT STONES

Among the techniques for dealing with common bile stones, choledochodu odenostomy (CDS) represents a useful alternative. This operation is in dicated mainly in patients,vith recurrent stones, giant stones, or con comitant common bile stricture and duct stones. At the present time mo st of the patients undergoing CDS have been already undergone endoscop ic retrograde cholangiography or ultrasonography to study the common b ile duct and the cause of symptoms. The common bile duct diameter is o f paramount importance when determining the feasibility of performing a CDS, the critical size being 1.2 cm. The most common operation is a side-to-side anastomosis employing absorbable sutures. Stomal patency is the most important factor for preventing classic complications such as cholangitis and sump syndrome. These complications are rare, being observed in only 5% of the patients. Long-term results of the operati on show that it is a safe procedure that should be considered a good o ption in selected patients with choledocholithiasis.