Choledochoduodenostomy for benign biliary tract disease in the elderly

Endoscopic sphincterotomy is an available nonoperative alternative treatment for recurrent or residual common bile duct stones. Nevertheless, immediate, intraoperative and definitive treatment is needed in patients with common duct stones and other pathologies that are prone to develop into such complication, which is important especially in aged high-risk patients during recurrent operations and nonoperative instrumental interventions. To evaluate the safety of choledochoduodenostomy in elderly patients, we reviewed our experience with 55 patients over the age of 70 years with benign biliary tract diseases. Even though the majority of patients (69%) had obstructive jaundice and were operated on urgently, there was one death (1.8%) due to cardiac failure, and nine (16.3%) early postoperative complications including subphrenic abscess, disruption of wound and pneumonia (one case of each), wound infection (three cases) and urinary tract infections (three cases). There were no complications related to the procedure itself. In a follow-up period of one to 12 years, neither cholangitis nor sump syndrome were documented.