RT Journal
A1 Thompson JE, Jr, Bennion RS
T1 THe surgical management of impacted common bile duct stones without sphincter ablation
JF Archives of Surgery
JO Archives of Surgery
YR 1989
FD October 1
VO 124
IS 10
SP 1216
OP 1220
DO 10.1001/archsurg.1989.01410100122021
UL http://dx.doi.org/10.1001/archsurg.1989.01410100122021
AB • Thirty-two consecutive patients with impacted ampullary or distal common bile duct stones were managed prospectively. Preoperative indications for surgery were obstructive jaundice in 13 patients (40.6%), acute cholangitis in 7 patients (21.9%), biliary pancreatitis in 6 patients (18.8%), acute cholecystitis in 5 patients (15.6%), and chronic cholecystitis in 1 patient (3.1%). No patient had a prior cholecystectomy, and all stones were removed retrograde during cholecystectomy and open-duct exploration. There were no deaths, one retained stone in the biliary radicals, two episodes of mild pancreatitis, one superficial wound infection, and one minor bile leak. All patients have done well on follow-up. This study demonstrated that impacted biliary stones can be consistently and successfully extracted by the supraduodenal approach with minimal morbidity and no mortality, without resorting to duodenotomy and sphincter ablation.(Arch Surg. 1989;124:1216-1220)