[Primary choledocholithiasis after side-to-side choledochojejunostomy].
Primary choledocholithiasis represents a quite unusual sequela of biliary tract surgery. Primary stones originate in the common bile duct and are soft, smooth, with a yellowish or brown-reddish colour, reproducing the shape of the duct in which arise. The Authors report a review of the cases observed in the division of General and Vascular Surgery-Department of Surgery and Surgical Emergencies of the University of Perugia. From January 1988 to December 1993, 577 laparotomic biliary tract operations were performed, and in 8 cases a re-operation was needed. Among the latter, particularly interesting were 2 cases of primary choledocholithiasis occurred in two patients with bilio-digestive anastomosis previously performed, i.e. two side-to-side Roux-en-Y or Braun loop choledochojejunostomies, respectively. Therefore, primary lithiasis following a choledochojejunostomy occurred when the bilio-digestive anastomoses were performed with the indication of a curative re-operation on the biliary tract. On the contrary, most choledochojejunostomies are performed as a palliative procedure in patients presenting a low survival rate not allowing to develop a Sump Syndrome and a consequent choledocholithiasis, which are long-term complications.
Covarelli
P
P
Dipartimento di Chirurgia ed Emergenze Chirurgiche, Università degli Studi di Perugia.
Cirocchi
R
R
Pacifici
A
A
Cagini
L
L
Mazieri
M
M
Goracci
G
G
Fabbri
C
C
Mosci
F
F
D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects / Q000379:methods; D002768:Choledochostomy / Q000009:adverse effects* / Q000379:methods*; D005260:Female; D042882:Gallstones / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012086:Reoperation
La calcolosi primaria consecutiva a coledoco-digiunostomia latero-laterale.