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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]
Although unusual, it is possible to have a common bile duct stone despite prior cholecystectomy. One study found that in patients diagnosed with choledocholithiasis, 28% had undergone prior cholecystectomy. Such stones are thought to be the result of stones missed at the time of the cholecystectomy, as opposed to the formation of new stones. [3]
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 ...
In cholecystectomy there is a slight risk (0.3–0.5%) of injury of the bile ducts, most commonly of the common bile duct. [6] This complication can range from mild forms, which are easy to address during the operation, to more severe forms. [6] If not addressed such injury can be debilitating and lead to considerable morbidity. [6]
There are two surgical options for cholecystectomy: Open cholecystectomy is performed via an abdominal incision below the lower right ribs. Recovery typically requires 3–5 days of hospitalization, with a return to normal diet a week after release and to normal activity several weeks after release. [13]
Cholangitis/sepsis: the incidence of cholangitis after biliary endoscopic sphincterotomy is between 1% and 3%. [1] Late complications: long-term complication vs of biliary endoscopic sphincterotomy include recurrent common bile duct stone, cholecystitis, cholangitis, hepatic abscess, papillary stenosis and biliary stricture. [12]
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: