Choledochodudenostomy for bile duct injuries: a less demanding option, in a demanding surgical situation
Keywords:Bile duct injury, Choledochoduodenostomy, Cholecystectomy
Cholecystectomy is one of the most common surgical procedure performed worldwide and therefore a common cause for iatrogenic biliary tract injury. Bile duct injuries are associated with significant morbidity and are a potentially fatal complication. Choledochodudenostomy in patients of post cholecystectomy bile duct injury can be done safely by experienced surgeons in CBD injuries distal to the confluence of the cystic and common hepatic duct after eradication of sepsis. Choledochoduodenostomy has its own technical advantages and it maintains the normal anatomy. As compared with a routine Roux-en-Y hepaticojejunostomy, CDD is technically easier, faster, requires less manipulation of the CBD, and is more physiological. We present a case report of a patient of laparoscopic cholecystectomy with CBD injury managed with choledochoduodenostomy who did extremely well after procedure with no immediate and delayed postoperative complication.
Sicklick JK, Camp MS, Lillemoe KD, Melton GB, Yeo CJ, Campbell KA, et al. Surgical management of bile duct injuries sustained during laparoscopic cholecystectomy:perioperative results in 200 patients. Ann Surg. 2005;241:786-92.
Huang ZQ. Laparoscopic cholecystectomy and changes in the treatment of cholelithiasis] Zhonghua Waike Zazhi. 1993;31:387–9.
Mishra PK, Saluja SS, Nayeem M, Sharma BC, Patil N. Bile duct injury-from injury to repair: An analysis of management and outcome. Indian J Surg. 2015;77:536-42.
Waage A, and Nilsson M. Iatrogenic bile duct injury: A population-based study of 152 776 cholecystectomies in the Swedish Inpatient Registry. Arch Surg. 2006;141:1207-13.
Nuzzo G, Giuliante F, Giovannini I, Ardito F, D'Acapito F, Vellone M, et al. Bile duct injury during laparoscopic cholecystectomy: Results of an Italian national survey on 56 591 cholecystectomies. Arch Surg. 2005;140:986-92.
Tantia O, Jain M, Khanna S, Sen B. Iatrogenic biliary injury:13,305 cholecystectomies experienced by a single surgical team over more than 13 years. Surg Endosc. 2008;22:1077-86.
Sanders RL. Indications for and value of Choledochoduodenostomy. Ann Surg. 1946;3:847–55.
Bektas H, Schrem H, Winny M, Klempnauer J. Surgical treatment and outcome of iatrogenic bile duct lesions after cholecystectomy and the impact of different clinical classification systems. Br J Surg. 2007;94:1119-27.
Riedel H. Uber den Zungenfoermigen fortstz des rechten Lebberlappens und seine pathognostiche bedentung fur die erkrankungen der Gallenblase nebst bemerkungen uber Gallensteinoperationen. Ben Kim Wschr. 1888;25:577-602.
Sprengel O. Uber einen Fall Von Extripation der Gallenblase mit Anlegung einer Communic..ation Zwischen Ductus Choledochus und Duodenum. Arch Klin Chir. 1891;42:550.
Mayo WJ. Some remarks on cases involving operative loss of continuity of the common bile duct:With the report of a case of anastomosis between the hepatic duct and the duodenum. Ann Surg. 1905;42:90-6.
Madden JL, Chun JY, Kandalaft S, Parekh M. Choledocho-duodenostomy: an unjustly maligned surgical procedure? Am J Surg. 1970;119(1):45-54.
Malik AA, Rather SA, Bari SUL, Wani KA. Long-term results of choledochoduodenostomy in benign biliary obstruction. World J Gastrointest Surg. 2012;4(2):36-40.
Baker AR, Neoptolemos JP, Leese T, James DC, Fossard DP. Long term follow-up of patients with side to side choledo-choduodenostomy and transduodenal sphincteroplasty. Ann Roy Coll Surg Engl. 1987;69(6):253-7.
Escudero-Fabre A, Escallon A Jr, Sack J, Halpern NB, Aldrete JS. Choledochoduodenostomy. Analysis of 71 cases followed for 5 to 15 years. Ann Surg. 1991;213(6):635-44.
Blankenstein JD, Terpstra OT. Early and late results following choledochoduodenostomy and choledochojejunostomy. HPB Surg. 1990;2(3):151-8.
Dagenshein GA. Choledochoduodenostomy: An 18 yr study of 175 consecutive cases. Surgery. 1974;76:319-24.
Gupta BS. Choledochoduodenostomy:a study of 28 consecutive cases. KUMJ. 2004;2(3):193-7.
Vogt DP, Hermann RE. Choledochoduodenostomy, choledochojejunostomy or sphincteroplasty for biliary and pancreatic disease. Ann Surg. 1981;193(2):161-8.
Khajanchee YS, Cassera MA, Hammill CW, Swanström LL, Hansen PD. Outcomes following laparoscopic choledochoduodenostomy in the management of benign biliary obstruction. J Gastrointest Surg. 2012;16:801-5.
Okamoto H, Maruyama S, Takahashi K, Kawashima K, Fukasawa T, Fujii H. Laparoscopic choledochoduodenostomy for biliary alleviation. Surg Sci. 2017;8:65–72.