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April 1969

Choledochoduodenostomy: In the Treatment of Stenosis in the Distal Common Duct

Author Affiliations

From Sanders Clinic and the Department of Surgery, University of Tennessee, Memphis.

Arch Surg. 1969;98(4):442-446. doi:10.1001/archsurg.1969.01340100074008

Shortly after the introduction of gallbladder surgery, operative procedures were extended to include the common bile duct. Choledochoduodenostomy was first performed by Riedel, in 1888,1 who intended to cut across the common duct and implant the severed end into the duodenum, but abandoned this idea and united by lateral anastomosis the dilated common duct to the duodenum. The patient died as a result of leakage of infected bile into the peritoneal cavity.

Sprengel,2 in 1891, reported the first recovery following choledochoduodenostomy; the patient was a woman on whom he had previously performed a cholecystectomy. W. J. Mayo,3 in 1905, reported successful treatment of stricture of the common duct following cholecystectomy and choledochotomy by suturing the end of the dilated portion of the duct to the duodenum.

The fear of ascending cholangitis has caused many surgeons to shun choledochoduodenostomy as a method of correcting distal-common duct obstruction. Experimental