Duodenal obstruction related to benign biliary tract disease.

Duodenal obstruction in six patients was related to biliary tract disease and previous abdominal surgery. Causes of obstruction were adhesions to the inflamed gallbladder, adhesions to the gallbladder bed after cholecystectomy, intramural hematoma after transduodenal exploration of the common bile duct and severe pancreatitis after common bile duct exploration. Measures that may possibly prevent duodenal obstruction include early recognition and treatment of cholelithiasis, positioning of omentum between duodenum and gallbladder bed after cholecystectomy, avoidance of transduodenal exploration where possible and careful duodenal closure if necessary, avoidance of forceful dilation during common bile duct exploration, and a decrease in the number of negative explorations by increased use of cystic duct cholangiography