Operative management of recurrent choledocholithiasis.

INTRODUCTION

With the advent of endoscopic and image-directed percutaneous approaches, it is increasingly uncommon to require a surgical approach for recurrent bile duct stones.

TECHNIQUE

We describe open side-to-side choledochoduodenostomy as one of the surgical options for recurrent bile duct stones. This procedure includes the following elements: exposure of the common bile duct, mobilization of the duodenum (Kocher maneuver), choledochotomy, inspection of the bile duct with a choledochoscopy, and anastomosis of the bile duct with the duodenum. Other options for operative management are discussed.

CONCLUSION

Surgical drainage procedures for recurrent bile duct stones can be performed for patients who fail to respond to endoscopic and nonoperative interventional treatments with good long-term outcomes.