[Indications for and comparisons between transduodenal papillostomy and choledochoduodenostomy].

Biliary lithiasis is still a subject of great interest. The aim of surgical treatment is removing common bile duct stones and assuring a good biliary outflow. In this study the authors report their experience in the surgical treatment of common bile duct stones and the indications for transduodenal papillostomy (PST) and latero-lateral choledochoduodenostomy (CDA). The results are similar to those in the international literature and are surely good for both the procedures. Papillostomy is the procedure of choice, unless there are specific contraindications, in the treatment of common bile duct lithiasis for the following reasons: good immediate and long-term results, low incidence of postoperative complications, prevention of recurrent lithiasis. Choledochoduodenostomy, when clearly indicated, offers good results and, when the anastomosis is large enough, also has a low incidence of postoperative complications. Finally PST and CDA are not alternative procedures but present precise indications. The authors stress the possibility of combining these two techniques, in selected cases, with good results.