Laparoscopic choledochoduodenostomy.

Choledochoduodenostomy is less often performed since the advent of ERCP and endoscopic sphincterotomy (ES). It may, however, still prove necessary in patients where ERCP and ES fail to provide long-term biliary drainage or when CBD stones recur after ES. We have performed laparoscopic choledochoduodenostomy in two patients (aged 66 and 71 years). Surgery was performed in one patient for recurrent CBD stones 25 years after cholecystectomy where three attempts at ERCP failed to cannulate the CBD. In the second patient it was performed for recurrent CBD stones 16 years after cholecystectomy and after two previous endoscopic sphincterotomies. Surgery was completed in just over 3 h in both cases and postoperative stay was 4 days. Laparoscopic choledochoduodenostomy is a viable technique which may prove valuable in the management of patients in whom ERCP and ES has failed to provide long-term biliary drainage.