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KMID : 0371319710130080055
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Journal of the Korean Surgical Society
1971 Volume.13 No. 8 p.55 ~ p.63
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The Significances of Transduodenal Common duct Exploration
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김종삼/Kim, C.S.
박정호/김희규/Park, C.H./Kim, H.K.
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Abstract
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Transduodenal approach for distal common duct exploration was occasionally indicated to impacted
stone or other causes of obstruction of the lower end of the common duct.
We had experienced 34 cases of additional duodenotomy among the 376 cases of biliary surgery
during the period about 5 years duration from Jan. 1966 to Oct. 1970. at surgical department, Ca
tholic Medical College.
Authors intened to report the 34 cases by reviewing of its indication, surgical method of appr
oach and complication, and compare statistically to the cases of usual common duct exploration
which was experienced in same period.
Following results were obtained.
1) Among the 376 cases of tatal biliary Surgery, 122 cases(33%) were treated by cholecyste
ctomy only, 185 cases(84.4%) by cholecystectomy and choledochotomy and 34 cases (15.6%) by
additional duodenotomy.
2) The incidence of sexual ratio of male to female was 41.9% to 58.1%.
3) The most frequent cause of surfical variation was impacted stone (67.6%) in the cases of
transduodenal amppullary choledochoduodenostomy and common duct stone (81.0%) in usual exp
loration of biliary tract.
4) The incidence of complications was 43 cases (19.6%). In the complicated 14 cases (41.2%)
among the cases of duodenotomy, wound disruption, dehescence, subphrenic abscess, external biliary
fistula, atelectasis and thrombophlebitis was 2 cases (5.9%) respectively. And in the 29 cases (15.7
%) among the usual common duct exploration, residual stone was 13 cases (7.0%), dehiscence,
adhesive ileus and atelectasis was 3 cases (1.6%) respectively. The incidence of associated compli
cation was more frequently noted in the case of additional duodenotomy than usual exploration of
common duct.
5) The mortality was 1.4% (3 cases). 2 cases were in the cases of usual common duct explora
tion and 1 case in the cases of additional duodenotomy.
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