Pathogenesis and Management of Choledocholithiasis

Abstract

Stones may be formed primarily in the common bile duct or may result from the passage of gallbladder stones through the cystic duct. Unless high grade ampullary obstruction is present, biliary drainage is not recommended at the original cholecystectomy and choledocholithotomy. A drainage procedure should be performed, however, in patients with recurrent stones that have the appearance of primary duct stones and in all patients requiring a third common bile duct exploration.