[Late complications of latero-lateral choledocho-duodenostomy. Physiopathology, diagnosis and therapy. Apropos of 6 cases].

Laterolateral choledochoduodenostomy is commonly used in the treatment of lithiasis and both benign and malignant stenosis of the main bile duct, and is regarded on all sides as safe and free from late complications. The latter, however, were noted in 6 personal cases and consisted of pain (5/6 cases), fever (4/6 cases), and dyspepsia (3/6 cases, icterus (1/6 cases). Surgery revealed recurrent or residual lithiasis (4 cases) and stenosis (4 cases). It is felt that the reflux of duodenal material into the main bile duct after creation of the anastomosis led to ascending cholangitis, stagnation and hence stenosis of the opening. Closure of the opening and extensive papilloplasty is not followed by immediate postoperative sequelae.