Unit of Clinical Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy.
S.C. Gastroenterologia ed Endoscopia Digestiva, Parma University Hospital, Parma, Italy.
Obes Surg. 2019 Jun;29(6):2005-2006. doi: 10.1007/s11695-019-03882-9.
In Roux-en-Y reconstructions, choledocholithiasis could represent a really challenging condition to treat which can be treated by a surgical-assisted ERCP. Only six cases of transjejunal laparoscopic-assisted ERCP (LAERCP) can be found in literature to date and no large series are present.
A young woman who had undergone a laparoscopic Roux-en-Y gastric bypass 2 years earlier came complaining recurrent abdominal pain. Radiologic exams found stones in the common bile duct and no signs of internal hernia. We therefore decided to perform a transjejunal LAERCP finding a concomitant internal hernia in the Petersen's space which was repaired at the same time.
The post-operative course was uneventful.
Transjejunal LAERCP is a feasible technique to deal with choledocholithiasis, and it allows at the same time to identify and treat concomitant conditions like internal hernias.
在 Roux-en-Y 重建中，胆总管结石可能是一种极具挑战性的治疗条件，可以通过手术辅助的 ERCP 进行治疗。迄今为止，文献中仅报道了 6 例经空肠腹腔镜辅助 ERCP（LAERCP）的病例，且尚无大型系列报道。
一名年轻女性在 2 年前接受了腹腔镜 Roux-en-Y 胃旁路手术后，出现反复腹痛。放射学检查发现胆总管结石，无内疝迹象。因此，我们决定进行经空肠 LAERCP，发现 Petersen 间隙同时存在内疝，并同时进行修补。
术后过程顺利。
经空肠 LAERCP 是治疗胆总管结石的一种可行技术，同时还可以发现和治疗内疝等伴随疾病。
