Surgical treatment could be an alternative for patients with recurring CBD stones. However, surgical treatment is a more complex and invasive method than ERCP, and should be reserved for selective patients at a high risk of recurrent biliary complications, such as those with irreversible severe dilatation of the CBD or other patients in whom ERCP fails. There are 2 commonly used surgical procedures to treat recurrent CBD stones, choledochoduodenostomy (CDS) and choledochojejunostomy (CJS), including hepaticojejunostomy. The choice is mainly up to the surgeons, considering patient's factors and plans for accessing the CBD and preventing recurrence or complications.
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