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Choledochoduodenostomy (CDD) is a surgical procedure to create an anastomosis, a surgical connection, between the common bile duct (CBD) and an alternative portion of the duodenum. [1] In healthy individuals, the CBD meets the pancreatic duct at the ampulla of Vater , which drains via the major duodenal papilla to the second part of duodenum. [ 2 ]
Postcholecystectomy syndrome (PCS) describes the presence of abdominal symptoms after a cholecystectomy (gallbladder removal). Symptoms occur in about 5 to 40 percent of patients who undergo cholecystectomy, [1] and can be transient, persistent or lifelong. [2] [3] The chronic condition is diagnosed in approximately 10% of postcholecystectomy ...
Opinions vary slightly on the maximum calibre of a normal CBD, but 6 mm is one accepted upper limit of normal [5] with a further 1mm diameter allowed for each decade over 60 years. It normally gets slightly dilated after cholecystectomy, with upper limit (95% prediction interval) being about 10 mm after a few months. [6]
Biliary microlithiasis refers to the creation of small gallstones less than 3 mm in diameter in the biliary duct or gallbladder. It has been suggested [1] as a cause of postcholecystectomy syndrome, or PCS, the symptoms of which include: Upset stomach, nausea, and vomiting. Gas, bloating, and diarrhea. Persistent pain in the upper right abdomen ...
The pathogenesis of this condition is recognized to encompass stenosis or dyskinesia of the sphincter of Oddi (especially after cholecystectomy); consequently the terms biliary dyskinesia, papillary stenosis, and postcholecystectomy syndrome have all been used to describe this condition. Both stenosis and dyskinesia can obstruct flow through ...
As a result, the CHD/CBD becomes obstructed by either scar or stone, resulting in obstructive jaundice. It can be divided into four types. Type I – No fistula present. Type IA – Presence of the cystic duct; Type IB – Obliteration of the cystic duct; Types II–IV – Fistula present. Type II – Defect smaller than 33% of the CHD diameter
Extraction of choledocholithiasis and/or intrahepatic stones: choledocholithiasis is the presence of gallstones within the common bile duct. They can be either primary (formed within the duct) or secondary (entering the duct from the gallbladder). Biliary endoscopic sphincterotomy allows for opening of the sphincter of Oddi, allowing stones to ...
When bile enters the duodenum (the first part of the small intestine), it aids in digesting the fat within food leaving the stomach. When the bile can not be properly propelled from the not-mechanically-obstructed gallbladder or can not flow out of the end of the common bile duct properly, there is a state of biliary dyskinesia.