Harbhajan Singh Telvinderjit Singh, Seang Sereibanndith, Roy Susmit Prosun, Majid Adeeb
Department of Surgery, Calvary Mater Hospital, Newcastle, NSW, Australia.
School of Medicine and Surgery, University of Newcastle, Newcastle, NSW, Australia.
SAGE Open Med Case Rep. 2022 Sep 29;10:2050313X221128093. doi: 10.1177/2050313X221128093. eCollection 2022.
Choledochotomy and choledochoduodenostomy were commonly used technique in the early twentieth century to extract bile duct stones. Endoscopic retrograde cholangiopancreatography and sphincterotomy revolutionised the scenario and is currently the preferred first-line option for managing choledocholithiasis. However, in certain circumstances, where endoscopic retrograde cholangiopancreatography fails, choledochotomy and choledochoduodenostomy are the only available options. We present the case of an 86-year-old female with a background of multiple previous presentations with biliary sepsis and ascending cholangitis requiring multiple endoscopic retrograde cholangiopancreatographies that failed to remove all stones in the common bile duct. She underwent a laparoscopic choledochotomy and choledochoduodenostomy that successfully resolved her common bile duct obstruction. Laparoscopic choledochotomy and choledochoduodenostomy reduce the length of hospital stay and help to minimise complications associated with open surgery.
胆总管切开术和胆总管十二指肠吻合术是20世纪早期常用的胆管结石取出技术。内镜逆行胰胆管造影术和括约肌切开术彻底改变了这种情况，目前是治疗胆总管结石的首选一线方案。然而，在某些情况下，内镜逆行胰胆管造影术失败时，胆总管切开术和胆总管十二指肠吻合术是唯一可行的选择。我们报告一例86岁女性病例，她既往有多次胆源性脓毒症和化脓性胆管炎发作史，需要多次内镜逆行胰胆管造影术，但未能清除胆总管内的所有结石。她接受了腹腔镜胆总管切开术和胆总管十二指肠吻合术，成功解除了胆总管梗阻。腹腔镜胆总管切开术和胆总管十二指肠吻合术可缩短住院时间，并有助于将与开放手术相关的并发症降至最低。
