Kaminski D L, Barner H B, Codd J E, Wolfe B M
Am J Surg. 1979 Feb;137(2):162-6. doi: 10.1016/0002-9610(79)90136-3.
Twenty-five patients were treated for retained, recurrent, or primary common duct stones by permanent drainage of the biliary tract with external choledochoduodenostomy. Twenty-one patients had common duct stones which became evident two to fifty years after the initial biliary tract procedure and which may represent stones formed in the common duct. Three recent patients had a clinical history of primary common duct stones, had stones which were soluble in chloroform-methanol solution, and had hepatic bile which was lithogenic as determined by evaluating the molar percentage of cholesterol, phospholipid, and bile salt in bile samples obtained at the time of choledochoduodenostomy. These data suggest that further stone formation is possible and that permanent bypass of the sphincter of Oddi is indicated to prevent recurrent bile duct obstruction. Long-term evaluation of the results of external choledochoduodenostomy indicates that the procedure is safe and effective in the prevention of recurrent biliary tract calculi.
25例患者因胆管残留结石、复发性结石或原发性胆总管结石，通过胆总管十二指肠外引流术进行永久性胆道引流治疗。21例患者的胆总管结石在初次胆道手术后2至50年才显现，可能代表在胆总管内形成的结石。最近的3例患者有原发性胆总管结石的临床病史，其结石可溶于氯仿 - 甲醇溶液，且通过评估胆总管十二指肠吻合术时获取的胆汁样本中胆固醇、磷脂和胆盐的摩尔百分比，发现其肝胆汁具有成石性。这些数据表明进一步形成结石是可能的，并且需要永久性绕过Oddi括约肌以防止复发性胆管梗阻。对胆总管十二指肠外引流术结果的长期评估表明，该手术在预防复发性胆道结石方面是安全有效的。
