Choledocholithiasis: A prospective study of spontaneous choledochal stone migration in symptomatic patients

Abstract

with post-cholecystectomy BDI and treated with small diameter hepaticojejunostomy (HJ) Roux-en-Y. Method: Between January 1992 and December 2014, All patients who underwent HJ Roux-en-Y for treatment of post-cholecystectomy BDI were retrospectively studied. Group A (HJ with a diameter 10mm or less) and group B (HJ with a diameter more than 10mm). Long-term follow up was done for detection of the rate of anastomotic stricture. Results: A total number of 320 patients were included in the study with 22 patients (6.9%) were missed during long-term follow up. Group A included 64 (20.5%) patients while group B included 256 (79.5%) patients. There was a significant difference in the level of injury between 2 groups (P = 0.028). The long-term follow up was performed after a median 75 months, range (2e246) for 298 patients. The overall long-term complications were higher within group A (15/62-24.2%) than group B (32/236-13.6%), (P = 0.041). The incidence of anastomotic stricture within group A was higher than group B (P = 0.043). Conclusion:The incidence of anastomotic stricture is higher in small diameter hepaticojejunostomy. Technical skills are important to ensure wide patent mucosa-tomucosa hepaticojejnostomy to avoid development of anastomotic stricture.