title: Laparoscopic choledochoduodenostomy for biliary stone disease: a single-center 10-year experience.
abstract: OBJECTIVE
  Patients with a dilated common bile duct (CBD) and multiple, primary, or recurrent stones are candidates for choledochoduodenostomy. This article reviews our technique and results of laparoscopic choledochoduodenostomy (LCDD) in patients with CBD stones.
  
  
  METHODS
  Prospectively maintained data of patients with a dilated CBD and multiple, primary, or recurrent CBD stones who underwent LCDD after laparoscopic CBD exploration (LCBDE) at a tertiary-care teaching hospital in New Delhi, India, during a 10-year period from April 2001 to March 2011 were analyzed.
  
  
  RESULTS
  During this period, of 195 patients who underwent LCBDE for CBD stones, 27 patients underwent LCDD. The mean age of patients was 45.7±13.5 years. There were 6 male and 21 female patients. Sixteen (59.2%) patients had jaundice at presentation. Average CBD diameter was 19.6±4.4 mm. On average, 11.5±15.7 stones were removed from the CBD. Mean operative time was 156.3±25.4 minutes. Mean operative blood loss was 143.3±85.5 mL. Average postoperative hospital stay was 6.4±3.8 days. CBD clearance was obtained in all cases. One patient had a bile leak that resolved with conservative treatment. There was no mortality. No patient has had recurrence of symptoms or cholangitis after a follow-up of up to 9 years.
  
  
  CONCLUSIONS
  LCDD can be safely performed in patients with a large stone burden and recurrent or primary CBD stones. Although it requires advanced laparoscopic skills, the benefits of a single-stage laparoscopic procedure can be extended to these patients safely with good results.
authors.affiliation: Department of Surgery, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India. drjchander@yahoo.com
authors.forename: Jagdish
authors.initials: J
authors.lastname: Chander
authors.forename: Vivek
authors.initials: V
authors.lastname: Mangla
authors.forename: Anubhav
authors.initials: A
authors.lastname: Vindal
authors.forename: Pawanindra
authors.initials: P
authors.lastname: Lal
authors.forename: Vinod K
authors.initials: VK
authors.lastname: Ramteke
mesh_terms: D000328:Adult; D000368:Aged; D002768:Choledochostomy / Q000379:methods*; D003135:Common Bile Duct / Q000473:pathology; D004108:Dilatation, Pathologic; D005260:Female; D042882:Gallstones / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D013536:Suture Techniques; D055815:Young Adult