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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]
Roux-en-Y hepatico jejuno stomy used to treat (macroscopic) bile duct obstruction which may arise due to: a common bile duct tumour or hepatic duct tumour (e.g. resection of cholangiocarcinoma) [5] a bile duct injury (e.g. cholecystectomy, iatrogenic, trauma) an infection/inflammation (e.g. pancreatic pseudocyst)
The purpose of biliary endoscopic sphincterotomy in the treatment of a bile leak is to reduce or eliminate the pressure gradient between the bile duct and the duodenum, encouraging transpapillary bile flow and allowing the leak to heal. [7] Others: Palliation of malignant biliary strictures; Gallbladder drainage; Biliary parasite removal; Sump ...
Other complications (less than 1%) may include heart and lung problems, infection in the bile duct called cholangitis, that can be life-threatening, and is regarded as a medical emergency. Using antibiotics before the procedure shows some benefits to prevent cholangitis and septicaemia. [25] In rare cases, ERCP can cause fatal complications. [26]
Some uses for this procedure includes: drainage of bile/infected bile to relieve obstructive jaundice, to place a stent to dilate a stricture in the biliary system, stone removal, and rendezvous technique [4] where guidewire from the common bile duct (CBD) meets with duodenoscope (coming from the oesophagus into the stomach and then duodenum) at the major duodenal papilla.
This procedure may be used if the stone is very large or if the duct anatomy is complex. [5] Typically, the gallbladder is then removed, an operation called cholecystectomy, to prevent a future occurrence of common bile duct obstruction or other complications. [6]
For patients whom complete removal of the biliary obstruction is not possible, a combination of a gastric bypass and hepaticojejunostomy can be used. [110] This can reestablish bile flow into the small intestine , thereby bypassing the blockage.
Cholecystostomy or (cholecystotomy) is a medical procedure used to drain the gallbladder through either a percutaneous or endoscopic approach. The procedure involves creating a stoma in the gallbladder, which can facilitate placement of a tube or stent for drainage, first performed by American surgeon, Dr. John Stough Bobbs, in 1867.
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