Background

Endoscopic interventions are the mainstay treatment for choledocholithiasis. However, failure ofstone extraction could be encountered in some cases. Also, some patients may have recurrent stones after previousendoscopic duct clearance. Choledechoduodenostomy (CDD) may be a good option for these patients. Herein, wepresent our experience regarding the safety and efficacy of CDD in the management of such patients.

Patients and methods

We retrospectively reviewed the data of 30 consecutive patients who underwent theprevious procedure in our tertiary care setting. Our main outcome was the incidence of short- and intermediatetermcomplications. Patients were followed for a minimum of 18 months after the operation.

Results

Twenty-five patients were performed via the open approach, while the remaining five were performed bylaparoscopy. The majority of cases (93.3%) had a side-to-side anastomosis, while only two cases had an end-tosideanastomosis. Laparoscopy was superior to the open approach in blood loss and hospital stay. However, it wasassociated with a significantly prolonged operative time. Regarding postoperative complications, wound infectionwas the most common one (33.3%). Other early complications included abdominal collection (10%), bile leakage(6.7%), ileus (6.7%), and pulmonary embolism (3.3%). Late complications included cholangitis (6.7%), whichresponded to medical treatment. No patients with sump syndrome or anastomotic stenosis were encounteredthroughout the follow-up period.

Conclusion

Apart from high wound infection rates, CDD is a feasible and effective procedure for the …