MANAGEMENT OF REMAINING COMMON DUCT STONES BY VARIOUS SOLVENTS AND BILIARY FLUSH REGIMEN

THE PROBLEM of the remaining common duct stones attains considerable significance when one is confronted with the necessity of advising another operation to a patient who has just undergone a recent major surgical procedure. An alternative nonoperative program that offers equal or better results is therefore highly desirable, particularly when one considers the increased morbidity and mortality rates associated with secondary operations on the biliary tract. The purpose of this investigation was to develop a regimen with an effectiveness that would warrant its use in this all too frequent problem in which postoperative choledochograms demonstrate the presence of remaining common duct stones. This report concerns the investigation of 113 solutions tested for their solvent action on gall stones and the effect of the most efficient agents on ductal and liver tissue. An improved, simplified biliary flush regimen is also presented.

The reports on the incidence of cholelithiasis in the general