The clinical observation and review of 50 cases who had been made by pass procedures for biliary disease at Department of Surgery. Kwangju Christian Hospital from January, 1985 to December, 1988 was performed.
@ES The results were obtained as follows :
@EN 1) Operative procedures were as follows; transduodenal sphincteroplasty; 16 cases(32%), choledochoduodenostomy; 22 cases(44%), and choledochojejunostomy; 12 cases(24%).
2) The most common age group was the 6th decade, and the ratio of male to female was 1 : 14.
3) The indications for by pass procedures of common bile duct were as follows : recurrent or residual stones; 19 cases(38%), dilated common bile duct with muddy stones; 14 cases(28%), intrahepatic duct stones; 9 cases(18%), common bile duct
stones
with
stenosis of sphinter; 4 cases(8%), and malignant disease; 4 cases(8%).
4) The preoperative diagnostic procedures were T-tube cholangiography, opeative cholangiography, ERCP, US, PTC, and abdominal CT.
5) Postoperative complications were wound infection (11 cases, 22%), repiratory infection (2 cases, 4%), GI trouble (12 cases, 24%), cholangitis (3 cases, 6%), residual stone (17 cases, 34%), pancreatitis (1 cases, 2%), and biliary fistula (1
case,
2%).
6) The treatment for residual stones after operation were choledochoscopic extration, saline irrigation and reoperation.
7) The operative mortality rate of choledochoduodenostomy and choledochojejunostomy was 2% and 4% respectively. The cause of death was sepsis.
|