Measurement of stoma size following choledochoduodenostomy by transduodenal cholangiography

Abstract

Previous reports, concerning the operation of choledochoduodenostomy have stressed the importance of an ‘adequate’ stoma. However, there does not appear to have been an attempt to measure the stoma size by some objective method. The results with a new technique for the assessment of the stoma and duct system postoperatively are reported. The method involves the use of a transnasal guided catheter system with selective catheterization of the common bile-duct via the stoma. Accurate delineation of the stoma and ducts is then possible. The stoma was successfully catheterized in 13 out of 16 attempts, and satisfactory radiographs were obtained in 1 other patient by a modification of the technique. The measurements of the maximum diameter of the stoma were considerably less than those reported previously; despite this the clinical result in the short term was good in all except the 2 patients in whom the stoma could not be demonstrated.