Bile sump syndrome

Last revised by Henry Knipe on 15 Apr 2019

Bile sump syndrome refers to a complication following a side-to-side choledochoduodenostomy. 

This complication occurs in ~1% of patients following a side-to-side choledochoduodenostomy. 

Recurrent abdominal pain, cholangitispancreatitis, or biliary obstruction 1.

A side-to-side choledochoduodenostomy is a procedure where a communication is formed between the mid-common bile duct and duodenum to prevent recurrent choledocholithiasis or biliary obstruction. Bile sump syndrome occurs when there is malfunction of the sphincter of Oddi and the distal common bile duct acts as a 'sump' or stagnant reservoir for stones and other debris.

Treatment typically involves endoscopic sphincterotomy, which allows decompression of the CBD distal to the level of ampulla 2. Reoccurrence is mainly due to heavy stone burden and stricturing disease. As well as repeat endoscopy, surgical options can be utilized 3

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