Management of Complex Biliary Stone Disease




Indications



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Open Common Bile Duct Exploration




  • Clearance of biliary obstruction due to calculus disease if endoscopic techniques (eg, endoscopic retrograde cholangiopancreatography) are unavailable, have failed, or are not feasible due to patient anatomy or status.




Transduodenal Sphincteroplasty




  • Impacted stone at the ampulla of Vater.
  • Previous attempt at common bile duct exploration.
  • Most often performed at the time of cholecystectomy when common bile duct exploration has failed to clear a stone impacted in the distal common bile duct.




Choledochoduodenostomy




  • Unresectable malignant distal common bile duct obstruction, as a palliative procedure.
  • Benign strictures of the distal common bile duct.
  • Salvage drainage procedure in the presence of large primary stones or numerous stones in the distal common bile duct.




Contraindications



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Open Common Bile Duct Exploration



Absolute




  • None.



Relative




  • Previous biliary bypass.

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Jan 10, 2019 | Posted by in UROLOGY | Comments Off on Management of Complex Biliary Stone Disease
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