Choledocho-duodenostomy
It is the anastomosis of the common bile duct with the duodenum either side to side or end to side.
History of choledocho-duodenostomy
In 1888 became the first choledochoduodenostomy, incidentally with bad result, was done by Riedel1.
Sprengel carried out in 1891 the first was a successful choledochoduodenostomy due to the presence of a choledochal stone2.
Mayo (1905) was the first to describe the application of this operation in a benign stricture of the ductus choledochus 3, while Sasse (1913) the indication area for choledochoduodenostomy was expanded to add papilla stenosis and pancreatic tumor4.
Indications for Choledocho-duodenostomy
Benign disorders
- Choledochal stones
- Hepatic stones
- Papillary stenosis / strictures
- post- cholecystectomy syndrome
- Pancreatitis(??)
- Benign strictures - extra hepatic bile ducts
- Parasitic infection
- Inflammation of the CBD
- Congenital disorders of the bile ducts
Malignant diseases
- Pancreatic carcinoma
- Extra hepatic biliary duct carcinoma (choliangio carcinoma)
Choledochoduodenostomy techniques
Sasse (1913) - anastomosis in retroduodenal part of CBD (obsolete), advantage - the duodenum and CBD lie absolutely over each other, no tension or stretch on anastomosis, disadvantage - damage to the pancreatic tissue
Some surgeons prefer transverse duodenostomy as the blood vesses run transversely over duodenum therefore less risk of blood loss than longitudinal incision
Classical Choledochoduodenostomy
Incision
References
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RIEDEL, BMCL (1892). Experiences about which gallstone disease with and without Jaundice. 116-119. Berlin publishing house of August Hirschwald.
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SPRENGEL, 0. (1891). About a case of gall extirpation of the bladder with attachment between a communication and ductus choledochus duodenum. Arch. Clin. C'hir. 42: 550-550.
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MAYO, WJ (1923). An address on the surgery of the hepatic and common bile ducts, Lancet 1: 1299-3002
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Sasse, F. (1913). About choledocho duodenostomy. Arch. Clin.Chir. 100: 969-984