Choledochostomy

Choledochostomy is a surgical operation that involves creating an anastomosis between the common bile duct (choledochus) and the lumen of the small or large intestine.

The purpose of choledochostomy is to ensure the outflow of bile in case of obstruction of the distal biliary tract. Indications for choledochostomy include cicatricial strictures of the terminal part of the common bile duct, tumors of the major duodenal papilla, and obstructive jaundice.

The operation is performed under general anesthesia. Access is carried out laparotomically or laparoscopically. After isolating and opening the common bile duct, an anastomosis is performed between the common bile duct and the small or large intestine.

Choledochostomy allows you to restore the flow of bile into the intestines, which prevents the development of cholangitis and bile leaks into the liver. Complications may include anastomotic leakage and peritonitis. After the operation, it is necessary to observe the surgeon and take choleretic drugs.

Choledochoduodenostomy (CDHS), or Whipple's operation, is a surgical procedure involving the creation of an artificial anastomosis between the bile duct and the duodenum through an incision in the abdominal wall under anesthesia. The bile duct is sanitized and expanded at the site of the cholangioscope cannula, which allows an artificial channel to be inserted between it and the drainage tube to empty the gallbladder into the intestinal fistula. In some cases, cholecystostomy is additionally used. The operation can be performed in connection with cholecystitis, cholelithiasis, choledochitis.

DHS is performed in case of ineffectiveness of conservative therapy in the presence of a blocked bile duct, complicated acalculous cholecystitis, biliary peritonitis, paralytic obstruction or obstructive jaundice, as well as to form an additional bile drainage route in case of trauma to the chest organs. At the same time, SDH is considered an intervention of choice and refers to radical operations.