Choledochoduodenostomy as an adjunct to choledocholithotomy.

An experience with 200 instances of choledochoduodenostomy validates the point of view that when the calculus-containing common bile duct measures 1.2 centimeters in internal diameter, choledochoduodenostomy is an excellent therapeutic and prophylactic procedure for the management of the existing and predicted complications of choledochlithiasis. It can be applied with a mortality that is not greater than that ordinarily associated with insertion of a T tube. Choledochoduodenostomy has the advantage of bypassing the obstructive factors distal to the anastomosis, especially with regard to recurrent or residual common bile duct stones, tubular stenosis of the transpancreatic portion of the common duct, stasis and sludge bile, primary soft stones and the stenosis and diverticula in the area of the vaterian segment.