Operative management of recurrent choledocholithiasis.
BACKGROUND
With the advent of endoscopic and image-directed percutaneous approaches, it is increasingly uncommon to require a surgical approach for recurrent bile duct stones.


METHODS
We describe open side-to-side choledochoduodenostomy as one of the surgical options for recurrent bile duct stones. This procedure includes the following elements: exposure of the common bile duct, mobilization of the duodenum (Kocher maneuver), choledochotomy, inspection of the bile duct with a choledochoscopy, and anastomosis of the bile duct with the duodenum. Other options for operative management are discussed.


CONCLUSIONS
Surgical drainage procedures for recurrent bile duct stones can be performed for patients who fail to respond to endoscopic and nonoperative interventional treatments with good long-term outcomes.
Department of Surgery, Penn State Milton S. Hershey Medical Center, Hershey, PA, USA.
Kazuhide
K
Matsushima
David I
DI
Soybel
D001662:Biliary Tract Surgical Procedures / Q000379:methods; D042883:Choledocholithiasis / Q000601:surgery*; D006801:Humans; D012008:Recurrence