Abstract
An 88-year-old woman admitted for fever and vomiting was diagnosed with cholecystitis and choledocholithiasis. Choledocholithotomy was conducted, and the common bile duct closed, including placement of a double-pigtail endoscopic retrograde biliary drainage (ERBD) tube. The ERBD tube was removed endoscopically on postoperative day (POD) 29. It is thought that patients with senile dementia may pull out T and C-tubes, resulting in biliary peritonitis. Complications are more frequent in patients undergoing primary closure of the common bile duct alone than in patients in whom T-tube drainage is used. We conclude that primary closure of the common bile duct with placement of a double-pigtail ERBD tube is clinically safe for choledocholithiasis patients with senile dementia; complications should be infrequent.
