Obstructive lithiasis of the lower bile duct discovered four decades after cholecystectomy and its management by ideal choledochotomy: a case report

Journal of Medical Case Reports

Case Report

Joel Noutakdie Tochie¹  Landry Wakheu Tchuenkam²  Joël Igor Kamla³  Arthur Georges Essomba⁴  Guy Aristide Bang⁴ 

[1] Anaesthesiology and Critical Care Units, Douala Laquintinie Hospital, Douala, Cameroon;Department of Surgery, Adlucem Hospital, Douala, Cameroon;Department of Surgery, Sangmelima Reference Hospital, Sangmelima, Cameroon;Faculty of Medicine and Pharmaceuticals Sciences, University of Ebolowa, Ebolowa, Cameroon;Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaoundé, Cameroon;Department of Surgery, Yaounde University Hospital Center, Yaoundé, Cameroon;

关键词: Choledocholithiasis;    Laparotomy;    Choledochotomy;    Biliary drainage;   

DOI  :  10.1186/s13256-023-04052-3

 received in 2023-04-17, accepted in 2023-06-21,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundResidual lithiasis is the presence of stones in the common bile duct, ignored after one or more biliary interventions. We report an atypical case of chronic symptomatic lithiasis of the lower bile duct occurring 41 years after biliary surgery, managed successfully by ideal choledochotomy.Case presentationA 68-year-old Black African female with several past laparotomies including a cholecystectomy forty-one years ago presented with hepatic colic-type pain that had been intermittent for several years but worsened recently. Her clinical, biological, and imaging test assessments were suggestive of a residual obstructive lithiasis of the lower common bile duct. Through an open right subcostal laparotomy approach, a dilated bile duct of approximately 3 cm was found and managed by transverse choledochotomy in which the stone was extracted in retrograde manner. After confirmation of disobstruction, a primitive bile duct suture without biliary drainage was performed and a tubular drain was positioned under the liver. The postoperative course was uneventful at follow-up of 30 days.ConclusionResidual choledocholithiasis can be avoided. We performed an ideal choledochotomy, of which the follow-up was simple.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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