The selective use of combined supraduodenal and transduodenal exploration of the common bile duct.

The results of combined supraduodenal and transduodenal exploration of the common bile duct in 42 selected cases are presented. The indications for this operation were: the presence of multiple calculi in the common bile duct; stones impacted in the ampullary region; residual stones in the common bile duct following previous surgery on the biliary tract; stricture at the papilla and pancreatitis associated with cholelithiasis. After the procedure no patient had residual stones in the common bile duct. Serious complications were infrequent; there were no postoperative deaths and post-operative pancreatitis occurred in only one patient.