MANAGEMENT OF RETAINED GALLSTONES OF ΤΗΕ COMMON BILE DUCT
Abstract
At the first Surgical Depatment in period 1979-1989 we were confronted with a series of 73 patients all proved to have one or more retained common bile duct stones, 64 of whom were managed operatively whereas the rest (9) were submitted to endoscopic sphincterotomy. All forementioned patients have had a biliary operation preceded either in our Department or elsewhere. Extensive reference is provided in our study as far as the symtoms, the diagnostic approach and the sorts of therapies eventually engaged are concerned. Ιn addition we venture a global review to the various therapeutic schemes advocated by current literature and present our aspects on the indications for applying E.R.C.P., intraoperative sphincteroplasty or cholepeptic anastomosis all encountered as different means to tackling the agreeably awkward problem of retained common bile duct stones.References
Allen Β, Shapiro Μ, May L.W.: Management of recurrent and residual common duct stones. Am. J. Surg. 142: 41, 1981.
Αυγερινός Α. , Μαρκόγλου Κ, Βαρνάβας Μ, και συν.: Η ενδοσκοπική σφιγκτηροτομή στη θεραπευτική αντιμετώπιση της χοληδοχολιθίασης.
Πρακτικά 9ου Πανελληνίου Συνεδρίου Γαστρεντερολογίας 1987. Ελ. Γαστρεντερολογία 1, 1988.
Bergdal L, Holmund Dew.: Retained bile duct stones. Acta Chir. Scand. 142: 145-149, 1976.
Birkett D.H, Williams L.F. : Choledoscopic remoνal of retained common duct stones via the T-tube tract. Am. J. Surg. 139: 531-534, 1980.
Britton D.L, Gill B.S, Tay/or R.M.R. et al.: The remoνal of retained gallestones from the common bile duct. Experience with sodium cholate infusion and the Burhenne catheter. Br. J. Surg. 62: 520-523, 1975.
Burhenne H.J.: Non operatiνe retained biliary tract stone extraction : Α new roentenologic technique. A.J.R., 117: 377-388, 1973.
Cotton Ρ.Β. : Endoscopic management of bile duct stones; (apples and oranges). Cut 25: 587, 1984.
Cotton Ρ.Β.: Nonoperatiνe remoνal of bile duct stones by duodenoscopic sphincterotomy. Br. J. Surg. 1980.
Demling L, Koch Η, Classen Μ. et al.: Endoskopishe papillotomie und Gallensteinentfernung. Dtsh Med. Wochenschr, 99: 2255-2257, 1974.
Gadacz T.R.: Efficiency of campul and the dissolution of biliary stones. J. Surg. Res, 26:378-380, 1979.
Gardener Β.: Current status of heparin dissolution of gall stones: Experimental and clinical obserνations. Am. J. Surg., 130: 293-295, 1975.
Glenn F.: Trends in surgical treatment of calculus disease of the biliary tract. Surg. Gynecol. Obstet. 140: 877, 1975.
Hawers R, Vallon A.G, Holton J.M, Cotton Ρ.Β.: Long term follow-up after duodenoscopic sphincterotomy for choledocholithiasis in patients
with prior cholecystectomy. Gastroint. Endoscopy 33 (2) 157, 1987.
Hicken N.F, McAllister A.J.: Operatiνe cholangiography as an aid in reducing the incidence of "oνerlooked" common bile duct stones. Α study of 1293 choledocholithotomies. Surgery, 35: 753-758, 1964.
Mack Ε.Α, Saito C, Goldfarb S. et al.: Α new agent for gallstone dissolution. Experimental and clinical eνaluation. Surg. Forum 29: 438-439, 1978.
Mazzariello R.: Reνiew of 220 cases of residual biliary tract calculitreated without reoperation. An eight year study. Surgery 73: 299- 306, 1973.
Moody F.G.: Surgical applications ot sphincteroplasty and choledochoduodenostomy. Surg. CI. North. Am. 61: 609, 1981.
Vogt D, Herman R.: Choledochoduodenostomy, choledochojejunostomy of sphincteroplasty for Billiary or Pancreatic Disease. Ann. Surg. 193: 161-169, 1981.
