Common cystic-choledocian environment
Keywords:
cholelithiasis, complicationsAbstract
Tbe authors refer to an anatomical-surgical entity which occurs in aged, long course litiasic patients. The pathogenesis of the entity remains obscure. lt is characterized
by a wide communication between the common bile duct and the gallbladder, whit disappearance of a recognisible cystic duct. Five cases are reported,
all of which evolved well. It is remarked: the impossib! lity of a pre-operatory diagnosis; the necessity of cavtious surgical exploration when the entity is suspected;
the necessity of a regulated approach: openfog of the gallbladder fundus, evacuation of the gall stones, exploration of the cavlty, exploration of the common
bile duct, subtotal cholecistectomy, and closure of the choledocal opening upon a T-tube, using for this the remaining vesicular stump.
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