Common Bile Duct Exploration

  • Jameson L. Chassin

Abstract

As pointed out by Way, Admirand, and Dunphy, the true incidence of CBD stones in patients undergoing surgery for gallstones is probably between 12% and 15% in the United States. By using indications essentially identical to those stated below and by performing routine preexploratory cystic duct cholangiography, Way performed CBD explorations in only 21% of 952 cholecystectomies. These explorations were positive for calculi in 65% of the patients explored. Of the 952 cholecystectomy cases, 14% had CBD stones. In 6 additional reports collected by Way in which routine cystic duct cholangiography was employed, the results were similar. On the other hand, the same author cited 3 other reports from the Lahey Clinic of cases in which preexploratory cholangiography was not performed. Here, of 33% of patients undergoing CBD exploration only 30% of the ducts contained stones. Whereas the use of routine cystic duct cholangiograms resulted in the recovery of CBD stones in over 14% of the cholecystectomies reported by Way and colleagues, the authors who omitted preexploratory cholangiography were able to discover CBD stones in only 10% of their cholecystectomy cases. In other words, routine preexploratory cholangiography markedly reduces the number of CBD explorations performed yet achieves a higher recovery rate of CBD stones (see Table 63–1).

Keywords

Bile Duct Cystic Duct Hepatic Duct Bile Duct Stone Residual Stone 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media New York 1994

Authors and Affiliations

  • Jameson L. Chassin
    • 1
    • 2
  1. 1.Clinical SurgeryNew York University School of MedicineNew YorkUSA
  2. 2.Department of SurgeryNew York Hospital Medical Center of QueensFlushingUSA

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