Surgical aspects of treatment a patient with choledocholithiasis after gastropancreatoduodenectomy resection

Abstract

Cholelithiasis is a common problem in surgery. The pathological basis of the disease is a imbalance between cholesterol, bilirubin and bile acid metabolism. There are several risk factors for cholelithiasis, both modifiable and non-modifiable. Complications of this pathology most often require surgical intervention: either planned or emergency. One of such complications is choledocholithiasis. Most often, choledocholithiasis occurs as a result of migration of stones from the gallbladder, less often of stones form in the bile ducts. In the world and Russian literature, many works are devoted to the etiology, pathogenesis and the treatment of patients with choledocholithiasis. The diagnosis is confirmed using advanced imaging methods, such as magnetic resonance cholangiopancreatography and endoscopic retrograde cholangiopancreatography. A widely used method of treatment is endoscopic retrograde cholangiopancreatography in combination with endoscopic papillosphincterotomy. However, in case of severe choledocholithiasis, including with an altered anatomical picture, standard methods do not always allow to achieve the desired result. This article describes a clinical case of successful treatment of a patient with choledocholithiasis that developed two years after gastropancreatoduodenal resection for adenocarcinoma of the major duodenal papilla.

Keywords

choledocholithiasis / pancreatoduodenal resection / acute cholangitis

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