[Spontaneous choledochoduodenostomy in gallbladder carcinoma with pancreatitis].
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The surgical treatment of cholelithiasis in patients with sickle cell anemia is rather frequently followed by the operative complications. In order to study the influence of pre-operative factors and post operative complications, 31 consecutive patients distributed in two groups has been studied. In group I, all the patients have been operated by conventional procedures with 43.75% of complications. In group II, a more appropriated technique and a better metabolic control ensured a lower morbidity (6.67%). There was no pos operative death in this series. Pre operative bilirubin levels was the only condition associated with increased pos operative morbidity.
Based on literature and personal data (146 choledochotomies) the authors have developed a scheme of contraindications, indications and conditions for using the precision suture of the choledochus in patients with benign lesions of bile ducts. For this method of completing choledochotomy to be realized, the indications should be correlated with the complex of conditions. To most important conditions the authors refer the possibility to use the precision technique as well as the delicate highly informative diagnostic and curative endocholedochal manipulations. The choice of the variant of the precision suture of the choledochus is influenced by a group of conditions responsible for the state of the hepatocholedochus. Based on the proposed scheme the precision suture was used in 62 patients. No complications resulting from using this method of completing choledochotomy were noted.
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