Department of Surgery, Barmherzige Schwestern Krankenhaus Wien, Stumpergasse 13, 1060, Vienna, Austria.
Department of Diagnostic and Interventional Radiology, Klinik Hietzing, Wolkersbergenstrasse 1, 1130, Vienna, Austria.
Obes Surg. 2021 Aug;31(8):3896-3898. doi: 10.1007/s11695-021-05472-0. Epub 2021 May 25.
Gallstone disease after bariatric surgery is a common condition due to the obesity and rapid weight loss. Because of increasing obesity amongst the population, and the gastric bypass having been established as the standard treatment for morbid obesity, the occurrence of bile duct stones after this kind of surgery remains a therapeutic dilemma. We present a case of obstructed choledocholithiasis with shrinking of the gallbladder and consequent cholangitis in a 69-year-old Caucasian male patient after a laparoscopic Roux-and-Y gastric bypass (LRYGB), who underwent a successful laparoscopic single-stage bile stone removal of the choledochal duct using intraoperative ultrasound and choledochoscopy. There are several techniques to manage choledocholithiasis after LRYGB. Laparoscopic choledochoscopy with concomitant cholecystectomy after bariatric surgery can be a safe procedure even for elderly patients.
肥胖症患者在接受减重手术后常出现胆石病，这与肥胖和快速减重有关。由于肥胖人群的增加，以及胃旁路手术已被确立为治疗病态肥胖的标准方法，因此这种手术后出现胆管结石仍然是一个治疗难题。我们报告了一例白人男性患者，年龄 69 岁，在接受腹腔镜 Roux-en-Y 胃旁路术（LRYGB）后发生阻塞性胆总管结石病，伴有胆囊缩小和随后的胆管炎。该患者在术中超声和胆管镜的引导下成功地进行了腹腔镜一期胆总管结石清除术。对于 LRYGB 后胆总管结石的处理有几种方法。对于老年患者来说，即使是肥胖患者，在减重手术后进行腹腔镜胆管镜检查联合胆囊切除术也是一种安全的方法。
