European Journal of Molecular & Clinical Medicine

Background: Common Bile Duct Stones (CBDS) are one of the medical conditions leading to surgical intervention. They may occur in 3% 14.7% of all patients for whom cholecystectomies are performed. When patients present with CBD STONES, the one important question that should be answered: what is the best modality of treatment under the given conditions? There are competing technologies and approaches for diagnosing CBDS regarding diagnostic performance characteristics, technical success, safety, and cost effectiveness.
Aim and Objectives of the study: The objective of the study to compare the outcomes of Choledochoduodenostomy (CDD) versus choledocholithotomy and insertion of a T-tube in subjects with multiple CBD stones.
Methodology: This study was conducted in the Dept. of Surgery, Tripura Medical College. we included a total of 60 subjects divided into two groups, Group A and Group B with 30 subjects in each group. Group A underwent choledocholithotomy and insertion of a T-tube and Group B underwent Choledochoduodenostomy. Details of the study were told to the patient and informed consent was taken. After obtaining consent, the patient underwent procedure as per the study design. We compared the parameters, mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin.
Results: We compared mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin between the two groups. The Mean operating time (minutes), mean duration of stay at hospital (days), frequency of wound infection and post-operative serum bilirubin in Group A were 68 ± 11.8, 8 ± 1.82, 11% and 0.78 ± 0.33 in Group B were 98.6 ± 10.1, 14 ± 3.21, 26% and 1.7 ± 0.97 respectively. There was statistically significant difference in all the parameters between the two groups.
Conclusion: Both Choledochoduodenostomy and T-tube drainage after CBD exploration are equally good procedures for the treatment of uncomplicated choledocholithiasis. However, choledocolithotomy and insertion of a T-tube is having significantly lower operating time and
less duration of stay at hospital. Therefore, it can be recommended for treatment in selective patients of choledocholithiasis.
 

Background:Humans have long known about jaundice. Obstructive jaundice is
common in general surgery. Intrahepatic or extrahepatic blockage can cause
obstructive jaundice. Most patients with suspected biliary blockage start with an
abdominal ultrasound. This study aims to determine the prevalence of obstructive
jaundice owing to choledocholithiasis in my hospital, the role of ultrasound in detecting
such cases, and the treatment options available at Princes Dusra Hospital Hyderabad.
Materials and Methods: Between June 2019 and June 2021, 24 patients with obstructive
jaundice due to choledocholithiasis were studied at Princes Esra Hospital in Hyderabad.
These patients received surgery. The proforma was used to assess these patients both
pre- and post-operatively.
Results: Obstructive jaundice due to choledocholithiasis was 0.14 percent in hospitals.
The patients were mostly female (16:4).Symptoms presented in decreasing order of
frequency. 100% jaundice, 95% abdominal pain, 50% nausea/vomiting, 50% itching
(35 percent),Fever with chills and rigours (25%) Steatorrhea (10%) and abdominal
mass (5%).Ultrasound showed stones in 16 (80%) and dilated CBD in all 24 (100%)
instances (100 percent ). 11 patients had choledocholithiasis. Four instances had
choledocholithiasis and cholelithiasis. The investigation found one incidence of
choledocholithiasis with CBD stricture. The most common surgical technique was
choledochoduodenostomy (50%) followed by choledochotomy with T-tube drainage
(40%) One case each of choledocho-jejunostomy and transduodenal sphincter. All
twenty instances had cholecystectomy. All cases were monitored for 1-6 months with no
complaints.
Conclusion:Patients with obstructive jaundice are more susceptible to infections due to
impaired liver function. It's also critical to identify specific risk factors in biliary tract
surgery patients. Our study shows that ultrasound is the cheapest, safest, and most
reliable diagnostic technique for postoperative jaundice. Despite the advent of
laparoscopic CBD exploration, open, internal, and external biliary drainage procedures
are still used successfully in areas lacking technology and experience.