Forty years without symptoms after choledochogastrostomy.

Introduction: The preferred surgical procedures for internal biliary drainage are choledochojejunostomy and choledochoduodenostomy. Cholangiogastrostomy is not recommended because of the potential risk of bile gastritis, and because reflux of gastric fluid into the biliary tree might occur and cause complications in the long run. Cholangiogastrostomy by surgery, endoscopy or by a combined fluoroscopic, endoscopic and laparoscopic approach have been described. However, these procedures were mostly used in patients with advanced malignant diseases and therefore data concerning the long-term risks of biliary drainage into the stomach are limited. To our best knowledge this is the first report about a patient who was free of symptoms during a follow-up period of several decades after choledochogastrostomy.