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Case report
One-stage fluoroscopic-guided laparoscopic transcystic papillary balloon dilation and laparoscopic cholecystectomy for the treatment of choledocholithiasis after Roux-en-Y reconstruction
  1. Teppei Kamada1,
  2. Hironori Ohdaira1,
  3. Eigoro Yamanouchi2 and
  4. Yutaka Suzuki1
  1. 1Surgery, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan
  2. 2Radiology, International University of Health and Welfare Hospital, Nasushiobara, Tochigi, Japan
  1. Correspondence to Dr Teppei Kamada; teppei0911show{at}yahoo.co.jp

Abstract

Patients with a history of gastrectomy have a higher incidence of cholecystocholedocholithiasis and morbidities. In particular, the management of choledocholithiasis with endoscopic retrograde cholangiopancreatography (ERCP) has been challenging in patients after Roux-en-Y or Billroth II reconstruction due to the altered gastrointestinal anatomy. A 92-year-old man presented with high fever. He had undergone laparoscopic distal gastrectomy with Roux-en-Y reconstruction 9 years earlier for gastric cancer. Choledocholithiasis was diagnosed and ERCP was attempted, but cannulation of the papilla of Vater failed. An elective one-stage operation was planned. One-stage fluoroscopic-guided laparoscopic transcystic papillary balloon dilation (LTPBD) and laparoscopic cholecystectomy (LC) were performed. The operation time was 130 min with 3 mL of intraoperative bleeding. The patient was discharged on postoperative day 3 with no complications. We report this case in which one-stage LTPBD and LC was successfully performed for a super-elderly patient with choledocholithiasis after Roux-en-Y reconstruction.

  • surgery
  • pancreas and biliary tract
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Footnotes

  • Contributors TK: study design, data collection, data analysis, writing. HO: critical revision. EY: critical revision. YS: final approval of the article. All authors read and approved the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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