TRANSDUODENAL EXPLORATION OF COMMON DUCT WITHOUT CHOLEDOCHOTOMY

Transduodenal exploration of the common duct without choledochotomy has been performed in eighty-two patients. The procedure is used in patients with suspected stones in the common duct and in patients with malfunction of the duodenal ampulla. Common duct stones can be removed through the ampullary end of the common duct without using choledochotomy or T tube drainage. Additional significant ampullary disease can be identified at the time of exploration. Malfunction of the duodenal papilla, usually stenosis, can be the precursor of pancreatitis. This malfunction can be diagnosed with reasonable certainty before frank pancreatitis develops if the following triad of findings is elicited: (1) pain immediately upon eating, (2) tenderness in the pancreatic area, and (3) a feeling of epigastric fullness and a sensitivity to tight clothing. © 1968.