Cholecysto-choledochostomy plus construction of subcutaneous cholecystic tunnel in treatment of choledocholith.
OBJECTIVE
To avoid the pitfalls of choledochotomy with T-tube drainage in the treatment of choledocholith.


METHODS
A novel operation was designed as cholecysto-choledochostomy plus construction of subcutaneous cholecystic tunnel. After the common bile duct was cut open and stones were removed, the gallbladder was appropriately dissociated and the cholecystic ampulla was incised. Then, the incision of the cholecystic ampulla was anastomosed to the opened common bile duct, and the cholecystic fundus was fixed out of the abdominal muscular stratum.


RESULTS
Twenty-one patients with choledocholith underwent this operation successfully and recovered well without postoperative complications. One of them was diagnosed as having recurrent stones in 2 years and 3 months after operation. Consequently, the subcutaneous cholecystic tunnel was opened under local anesthesia to remove successfully the stones with choledochoscope.


CONCLUSIONS
This operation provides a convenient way to remove postoperative recurrent stones with choledochoscope and avoid receliotomy.
Tang
Li-Jun
LJ
PLA Centre of General Surgery, Chengdu General Hospital, Chengdu 610083, China. tljwhj@yahoo.com.cn
Tian
Fu-Zhou
FZ
Cai
Zhong-Hong
ZH
D000328:Adult; D000368:Aged; D002767:Cholecystostomy / Q000379:methods*; D042883:Choledocholithiasis / Q000175:diagnosis / Q000601:surgery*; D002768:Choledochostomy / Q000379:methods*; D016145:Endoscopy, Digestive System; D005260:Female; D005704:Gallbladder / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence