Long‐Term Results of Choledochoduodenostomy

Escudero-Fabre, A., Escallon, A., Sack, J., Halpern, N.B., Aldrete, J.S. (1991) Cholodechoduodenostomy. Analysis of 71 cases followed for 5 to 15 years. Annuals of Surgery; 213: 635-644. To investigate the long-term effectiveness of choledochoduodenostomy (CDD), the experience with 71 patients followed for 5 or more years after CDD was analyzed retrospectively. From 1968 to 1984, 134 patients underwent CDD. Eight patients (6%) died in the immeditate postoperative period, 55 left the hospital, 8 of them were lost to follow-up, and 47 were followed but died before 5 years elapsed after CDD. The remaining 71 patients form the date base for this analysis: 38 were followed for more than 5 years, 25 were followed for more than 10 years and 8 were followed for more than 15 years ( 12.1 years _ 1.3 SEM). Choledocholithiasis, chronic pancreatitis and postoperative stricture were the indications for CDD. Cholangitis was observed in only three patients. The diameter of the common bile duct (CBD) was large in most patients ( 18 mm _ 0.9 SEM). These results infer that CDD is effective to treat non-neoplastic obstructing lesions of the distal CBD on a long-term basis and that the presence of a dilated CBD (more than 16 mm) that allows the construction of a CDD more than 14 mm is essential to obtain good results.