Weledji Elroy Patrick, Mbengawo Ndiformuche Zikirou, Zouna Frank
Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, S.W. Region, Cameroon.
Regional Hospital Limbe, Limbe, S.W. Region, Cameroon.
J Surg Case Rep. 2022 Apr 25;2022(4):rjac148. doi: 10.1093/jscr/rjac148. eCollection 2022 Apr.
A bypass procedure such as a hepaticoduodenostomy may be an alternative to the traditional choledochoduodenostomy in the management of the retained, impacted distal common bile duct stone especially in the presence of sepsis. In low-resource settings with lack of fluoroscopy, fibreoptic instruments (choledoscope) or radiologically guided wire baskets or balloons for stone retrieval, there are operative hazards in blindly exploring the common bile duct. We present herein a hepaticoduodenostomy performed for a retained, impacted distal common bile duct stone in a low-resource setting with a good outcome. This impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing the dehiscence of the cystic duct stump as a result of distal biliary obstruction.
在处理残留的、嵌顿的胆总管远端结石时，尤其是存在脓毒症的情况下，诸如肝十二指肠吻合术这样的旁路手术可能是传统胆总管十二指肠吻合术的替代方法。在缺乏荧光透视、纤维光学器械（胆道镜）或用于取石的放射学引导钢丝篮或球囊的资源匮乏地区，盲目探查胆总管存在手术风险。我们在此介绍在资源匮乏地区为残留的、嵌顿的胆总管远端结石实施肝十二指肠吻合术并取得良好效果的病例。这块嵌顿结石因远端胆管梗阻导致胆囊管残端裂开，使急性胆囊炎的开腹胆囊切除术出现了并发症。
