An analytic review of the clinical records of 24 cases who had been made by-pass surgery of common bile duct among 73 cases of cholelithiasis at Department of Surgery, Chungnam National University Hospital from April, 1974 to April, 1979.
The results were obtained as follows
1. The incidence of cholelithiasis was following orders : common bile duct stone : 54. 8 %, gallbladder stone : 46. 6% and intrahepatic stone : 15. 1%
2. The incidence was hight in 30-49 years and mean age was 46.6 and males predo￢minated over females by 1.9 : 1 in cholelithiasis.
3. Operative procedures were as follows : choledochoduodenostomy : 18 cases(75%), choledochojejunostomy : 5 cases (20.8%), and sphincteroplasty : 1 case(4. 2%).
4. The indications for by-pass surgery of common bile duct were as follows : intrahe￢patic stone : 11 cases(45. 8%,), dilated common bile duct with multiple muddy stone : 8 cases (33.3%), residual or recurrent stone : 4 cases(16.7 0), and common bile duct stone with stenosis of sphincter : 1 case(4.2%).
5. The incidence was hight in 30-49 years and males predominated over females by 1.7 : 1 in operated patients with by-pass surgery of common bile duct.
6. The prominent symptoms and signs were pain in right upper quadrant of abdomen, tenderness, nausea and vomiting, jaundice, fever and chillness, indigestion and hepatom￢egaly etc. in order of frequency.
7. The rate of positive findings was 63.6% in oral cholecystogram or intravenous cholangiogram preoperatively.
8. Postoperative complications were wound infection in 2 cases(8.3%). respiratory infection in 2 cases(8.3%) residual stone in common bile duct in 1 case(4.2%) etc. choledochoduodenostomy was lesser incidence of complication than choledochojejunostomy.
9. The :operative mortality was 4.2% and severe jaundice and hepatic coma were the cause of death.
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