Obstruction of the common and hepatic bile ducts by calculi has been a challenging surgical problem since Abbe performed the first successful choledocholithotomy in 1889.1 In patients who have undergone cholecystectomy and choledocholithotomy, subsequent calculous obstruction of the bile ducts is the result of retained stones, that is, stones missed at the time of choledocholithotomy, or recurrent stones, that is, stones re-formed within the ductal system after choledocholithotomy. Recurrent stones may form secondary to a structural abnormality of the bile ducts, or they may occur without apparent cause. This study is primarily concerned with those patients who have idiopathic recurrent biliary stones.
Forty-six patients underwent choledocholithotomy at the Mayo Clinic on at least two occasions during the 11-year period from Jan 1, 1950, through Dec 31, 1960. Since some of these patients had undergone choledocholithotomy prior to 1950, first or second choledocholithotomy as used in this paper will