Choledocholithotomy

Choledocholithotomy: an effective surgical procedure for the treatment of stones in the common bile duct

Introduction

Choledocholithotomy is a surgical procedure designed to remove stones from the common bile duct. This is an intervention that is carried out to restore normal bile flow and prevent complications associated with obstruction in the biliary tract. In this article we will consider the main aspects of choledocholithotomy, its indications, the process of implementation and postoperative care.

Description of the procedure

Choledocholithotomy is an operation performed to remove stones found in the common bile duct. Choledocholites (stones in the common bile duct) can form in the gallbladder and migrate into the common bile duct, causing it to become blocked. This can lead to acute jaundice, pain in the right hypochondrium, inflammation of the bile duct and other serious complications.

Choledocholithotomy can be performed either through an open surgical approach or using minimally invasive techniques such as endoscopic retrograde choledocholithotomy (ERCP) or laparoscopic choledocholithotomy. The choice of method depends on various factors, including the size and number of stones, the presence of complications, and the availability of the necessary equipment and the experience of the surgeon.

Indications

Choledocholithotomy is recommended for patients with confirmed presence of stones in the common bile duct that cause clinical symptoms or complications. Common indications for the procedure include:

1. Obstruction of the common bile duct by a stone or stones.
2. Recurrent jaundice or acute pancreatitis.
3. The presence of stones in the common bile duct, identified during examination of other bile ducts.

Execution process

Choledocholithotomy can be performed using various methods. Depending on the approach chosen, the procedure may be performed in an operating room or an endoscopic treatment room. The main steps of the process include:

1. Anesthesia: The patient is given general anesthesia to ensure comfort during the procedure.
2. Access: The surgeon creates access to the common bile duct using an open or minimally invasive approach.
3. Identification and incision: Once stones are found in the common bile duct, the surgeon makes an incision to remove the stones and restore normal bile flow. In open choledocholithotomy, the incision is made on the abdominal wall, while endoscopic retrograde choledocholithotomy uses an endoscopic approach through the mouth or colon.
4. Stone removal: The surgeon removes stones from the common bile duct using instruments such as tweezers or special grasping devices.
5. Drainage: After stone removal, it may be necessary to install a drainage catheter to facilitate the flow of bile and prevent possible complications.
6. Closure and final steps: The incision in the common bile duct is closed and the procedure is completed according to the chosen method.

Post-operative care

After choledocholithotomy, patients are usually monitored by medical personnel to review and evaluate their response to the procedure. It is important to monitor for possible complications, such as infection, bleeding, or bile duct obstruction, and take appropriate measures.

Patients may be prescribed antibiotics and medications to relieve pain and inflammation. Diet may be restricted in the first days after surgery, and patients may be instructed to gradually return to a normal diet.

Recovery from choledocholithotomy usually takes several weeks, during which patients should follow the doctor's recommendations and attend regular follow-up examinations. In most cases, the results of the surgery are favorable and patients experience relief from symptoms associated with common bile duct stones.

Conclusion

Choledocholithotomy is an effective and widely used treatment for stones in the common bile duct. Thanks to the various approaches available and modern technology, this procedure has become safer and less invasive. However, as with any surgical procedure, it is not without risks and requires competent medical intervention. Patients suffering from common bile duct stones should see a qualified surgeon to evaluate their case and determine the best treatment plan.

Choledocholithotomy is a surgical operation in which stones are removed from the common bile duct. This operation is one of the most common treatments for cholelithiasis, which is characterized by the formation of stones in the bile duct.

Choledochotomy is performed under general anesthesia and requires a highly qualified surgeon. During the operation, the surgeon makes an incision in the area of ​​the bile duct, then removes the stone, which causes bile retention and inflammation in the duct. After removing the stone, the surgeon checks the condition of the duct and, if necessary, cleans it.

Choledochotomy is about 90% effective, but there is a risk of complications such as bleeding, duct damage, or infection. In most cases, these complications can be eliminated through additional procedures.

In general, choledocholithotomy is an effective and safe method of treating cholelithiasis. However, before performing this operation, it is necessary to carefully assess the patient's condition and conduct the necessary examinations.