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Journal of Gastrointestinal Surgery

, Volume 16, Issue 4, pp 801–805 | Cite as

Outcomes Following Laparoscopic Choledochoduodenostomy in the Management of Benign Biliary Obstruction

  • Yashodhan S. Khajanchee
  • Maria A. Cassera
  • Chet W. Hammill
  • Lee L. Swanström
  • Paul D. HansenEmail author
Original Article

Abstract

Introduction

With the advent of endoscopic retrograde choledochoduodenostomy, the need for choledochoduodenostomy to treat common bile duct obstruction is less common, but occasionally required.

Methods

Patients considered for laparoscopic choledochoduodenostomy secondary to benign conditions between 1999 and 2009 at a single institution were included. Charts were retrospectively reviewed for preoperative, operative, and long-term outcomes data.

Results

Twenty patients were identified; 15 with chronic choledocholithiasis causing benign biliary obstruction or chronic recurrent cholangitis, 3 with chronic relapsing pancreatitis, and 2 with distal common bile duct strictures. Mean operative time was 270 min. No major operative complications were reported. Five patients with severe adhesions or portal hypertension required conversion to laparotomy. Median hospital stay was 6 days (range, 2–32). Postoperatively, three (20%) patients completed laparoscopically and three (66.7%) patients converted to laparotomy had complications. In addition, one death due to myocardial infarction was reported 4 weeks after hospital discharge. With an average follow-up of 21 months, only one patient (5%) developed recurrent symptoms.

Conclusion

Laparoscopic choledochoduodenostomy is a useful technique in patients with benign, refractory common bile duct obstruction. This technically demanding procedure is feasible; however, the associated comorbidities in this complex group of patients result in a relatively high complication rate.

Keywords

Laparoscopic choledochoduodenostomy ERCP Sump syndrome Choledochalithiasis 

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Copyright information

© The Society for Surgery of the Alimentary Tract 2012

Authors and Affiliations

  • Yashodhan S. Khajanchee
    • 1
  • Maria A. Cassera
    • 1
    • 2
  • Chet W. Hammill
    • 1
    • 2
  • Lee L. Swanström
    • 1
    • 2
  • Paul D. Hansen
    • 1
    • 2
    • 3
    Email author
  1. 1.Hepatobiliary and Pancreatic Surgery ProgramProvidence Portland Medical CenterPortlandUSA
  2. 2.Gastrointestinal and Minimally Invasive Surgery DivisionThe Oregon ClinicPortlandUSA
  3. 3.Surgical Oncology and Liver and Pancreas Surgery ProgramProvidence Portland Medical CenterPortlandUSA

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