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Dr. Andrew Rynne
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Dr. Andrew Rynne

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Exp 50 years

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Should I Consider Duodenocholecystostomy For Recurrence Of Stones After ERCP?

Yes I had my gallbladder removed ten years ago. I recently developed jaundice due to stones obstruction in the main biliary duct. Stones were removed via ERCP. However I was told that I should have a choleduodenonostomy in case I develop more stones in the future. Is this possible?
Mon, 1 Sep 2014
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Gastroenterologist, Surgical,  's  Response
Hi, How are you? My name is Dr Suresh Raghavaiah. I am a surgical gastroenterologist and I hope to answer your question today.
I am sorry you are having these symptoms. But by the sound of it, You seem to have gotten all the stones cleared from the bile duct. The question is, did the stones affect the bile duct in any way? Long standing stones usually cause infection and later lead to narrowing or "stricture" formation in the bile duct. This will cause problems, esp if you end up forming more stones in the bile duct and these will not be able to pass down into the intestine. But if your bile duct is healthy, I do not see a reason for prophylactic Surgical intervention of any kind. If the ERCP was straight forward, then I would advise you for a repeat ERCP later (In case you should develop more stones).
In my personal opinion a prophylactic Choledocho duodenostomy would be a bit of an "overkill" esp if the bile duct is normal.

Hope this helps you and hope you start to feel better.
Please do not hesitate to write back for any further clarifications.

Dr Suresh Raghavaiah
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Should I Consider Duodenocholecystostomy For Recurrence Of Stones After ERCP?

Hi, How are you? My name is Dr Suresh Raghavaiah. I am a surgical gastroenterologist and I hope to answer your question today. I am sorry you are having these symptoms. But by the sound of it, You seem to have gotten all the stones cleared from the bile duct. The question is, did the stones affect the bile duct in any way? Long standing stones usually cause infection and later lead to narrowing or stricture formation in the bile duct. This will cause problems, esp if you end up forming more stones in the bile duct and these will not be able to pass down into the intestine. But if your bile duct is healthy, I do not see a reason for prophylactic Surgical intervention of any kind. If the ERCP was straight forward, then I would advise you for a repeat ERCP later (In case you should develop more stones). In my personal opinion a prophylactic Choledocho duodenostomy would be a bit of an overkill esp if the bile duct is normal. Hope this helps you and hope you start to feel better. Please do not hesitate to write back for any further clarifications. Dr Suresh Raghavaiah