Abstract:

Background: The gold standard current treatment for common bile duct (CBD) stones is stone extraction via endoscopic retrograde cholangiopancreatography (ERCP). In ERCP failed cases, alternative surgical treatment methods come to the fore. Choledochoduodenostomy (CDD), which is a traditional method, is one of them. We aimed to present our conventional CDD results in ERCP failed patients. Methods: Between March 2015 and February 2022, clinicodemographics, perioperative findings, and postoperative results of 23 ERCP failed patients with underwent CDD for CBD stones were analyzed retrospecificley Results: The median age was 71 (41-85), and 13 (56%) were female. Of the patients, 5 (21%) had cholecystectomy and 7 (30%) had gastrectomy + gastroenterostomy, previously. The most common presenting symptom was abdominal pain (39%). The median number of failed ERCPs was 1 (1-6), and the reasons for failure were gastroenterostomy in 7 patients, impacted stones in 9, multiple and/or large stones in 6, and papillary opening anomaly in 1. The median CBD diameter was 15 (10-40) mm. The median operation time was 120 (60-240) minutes, and no perioperative complication developed. The median length of hospital stay was 7 (4-14) days. In the early postoperative period, wound infection was observed in 2 (8%) patients, and evisceration was observed in 1 (4%). There was no mortality. The mean follow-up period was 27 (2-77) months, and incisional hernia was encountered in 2 (8%) patients in the late postoperative period. There was no evidence of Sump syndrome within the follow-up period. Conclusion: In treatment of ERCP failed CBD stones, CDD is an effective and safe surgical treatment method in selected patients.

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