J.Jpn. Surg. Soc.. 81(7): 654-665, 1980

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Original article

SURGICAL TREATMENT OF CHOLEDOCHOLITHIASIS: FOLLOW-UP RESULTS OF T-TUBE DRAINAGE FOR CHOLELITHIASIS

Out of 300 cases subjected to T-tube drainage for cholecystolithiasis and cholecystocholedocholithiasis 238 cases were followed up for periods from 1 to 16 years. Follow-up studies were based on questionnaries and personal interviews in 238, and additional laboratory examination in 100 cases. The results of the total 238 cases at follow-up were: 180 good (75.6%), 34 fair (14.2%) and 9 poor (3.4%). Of the 9 poor cases, 7 had residual stones and 2 had recurrent stones. All but one of these 9 cases have already undergone reoperation at our hospital for gallstones.
With regard to the results of laboratory tests of the 100 patients, anemia and hepatic function had improved remarkably between the time of discharge and the follow-up study. Cholangiographically, the caliber of the extrahepatic bile duct at follow-up, as compared to the preoperative state, was found to be significantly decreased in both cases with cholesterol stones and calcium bilirubinate stones.Furthermore, reduction in the diameter of the bile duct was greater when the dilatation of the bile duct was larger, regardless of the nature of gallstones. Based upon these results, it is thought that, choledocholithiasis together with T-tube drainage is sufficient for the treatment of choledocholithiasis, regardless of the type of gallstones, except when small stones or mud are thought to be present in the bile duct. This should be undertaken following operative cholangiography, pressure studies of the bile duct, choledochoscopy and examination of the passage of the papilla of Vater by the probe, when stricture of the papilla of Vater is apparent.

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