SELECTION OF OPTIMAL SURGICAL PROCEDURE IN TREATMENT OF COMPLICATED FORMS OF CHOLEDOCHOLITHIASIS

Abstract

Results of surgical treatment of patients with complicated forms of choledocholithiasis, treated between October 1st, 1999 and October 1st, 2004, are presented in this paper. During that period, at our clinic, 9802 patients were operated, 2421 (24,7%) of which due to biliary calculosis. 374 (15,8%) of patients with performed cholecystectomy had choledocholithiasis, which required more complex surgical procedure. In the majority of patients (305 of them) the problem was sucessfully managed with choledocholithotomy with T- tube drainage of the choledochal duct. However, 69 patients had complicated choledocholithiasis. Therefore, we had to modify the operation procedure and to use one of the biliodigestive derivations. In 33 patients we performed choledochojejunostomy according to Roux-en-Y, in 20 patients transduodenal papillotomy and papilloplasty, and in 16 patients choledochoduodenostomic anastomoses. The observed parameters and elements of comparasion were: mortality, morbidity, duration of hospitalisation and rate of recurrences. We had the best results in the group of patients where choledochojejunostomy according to Roux-en-Y was performed.

Keywords

• choledocholithiasis
• biliodigestive derivations
• surgical treatment