Choledochodudenostomy Revisited: The Present Scenario

Abstract

Background Choledochoduodenostomy as a surgical management of common bile duct obstruction aims at free flow of bile to duodenum, being more physiological, relatively quick, simple and with fewer anastomotic sites. Objectives Investigate the safety and long term outcome of this procedure and to access its uses in present era of endoscopy and interventional radiology.. Material and methods- Study was conducted in the Department of Surgery at Shri Guru Ram Rai Institute of Health and Medical Sciences, Dehradun. Over a period of 7 years retrospectively until 2015 and prospectively from then on till december 2017. A total of 34 patients who underwent Choledochoduodenostomy(CDD) were evaluated by going through their hospital records and regular OPD follow up. Results – the results were encouraging with 33 of our patients did well in the long term follow up. Average duration of surgery was 115 minutes. Postoperatively one patient had haematemesis, later on she went to develop recurrent stricture. She later also developed long-term impairment of hepatic functions. No case of feared sump syndrome, or reflux cholangitis was observed. Conclusions Authors are of the view that Side to side choledochoduodenostomy, should be considered by surgeons, as a simpler, less technically demanding and physiologically better procedure. It does not carry the problems usually feared with it. The excellent long term results of this series allow us to have more frequent but indicated use of this procedure, even in the young patients.