Choledochoduodenostomy in the Present Era: Specific Indications and Outcomes
Aim: To determine the specific indications and outcomes of patients undergoing choledochoduodenostomy (CDD) in the current era of endoscopy and interventional radiology. Materials and methods: This retrospective study was conducted at Dr. Ram Manohar Lohia Institute of Medical Sciences, Lucknow, India, over a period of 6 years from January 2011 to December 2016. Twenty-six patients who underwent CDD within this period were evaluated. Preoperatively, all the patients underwent abdominal ultrasonography and magnetic resonance cholangiopancreatography along with routine blood investigations and were evaluated for medical comorbidities. The patients were followed up for a variable period of 6 months to 4 years. Results: In our study, the indications for CDD included large impacted stones; choledocholithiasis with stricture; recurrent stones; and common bile duct stone with stricture and cholecystoduodenal fistula. The mean of length of hospital stay was 9.2 days. The overall morbidity was 30% without any mortality. There were no cases of residual stones, bile leak, or hemorrhage; and none developed alkaline gastritis, sump syndrome, or cholangitis in the follow-up period. Conclusion: Choledochoduodenostomy has a definite role in the management of bile duct stones, especially in benign biliary tract obstruction. The proportion of cases requiring this approach is diminishing because of nonoperative techniques available, but it will not be eliminated by them based on current trends.