Surgical strategy for recurrent common bile duct stones: a 10-year experience of a single center

This study aimed to report the experience of treating recurrent CBDS. A total of 106 consecutive cases of recurrent CBDS treated from January 2006 to December 2015 were included. During surgery, the choledochoscopic pass-through test was performed to assess the structure and function of the duodenal papilla. The choledochoscopic pass-through test revealed 62 patients (58.49%) with incomplete closure of the lower end of the common bile duct, and 28 (26.42%) with stenosis at the lower common bile duct. Intra-operative bile bacterial culture was positive in 98 (92.45%) patients. The rate of complete stone clearance was 99.1%. The total recurrence rate of CBDS was 3.13%. The long-term success rate of surgical treatment (excellent and good) reached 92.7% .Duodenal papilla (Oddi sphincter) dysfunction is the main cause of recurrent CBDS. Common bile duct exploration with stone extraction, hilar ductoplasty, and Roux-en-Y hepaticojejunostomy can effectively eliminate the recurrence of CBDS and reduce the incidence of post-hepaticojejunostomy complications. Thus, it is an optimal surgical procedure for recurrent CBDS.
Source: Updates in Surgery - Category: Surgery Source Type: research