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Laparoscopic Choledochal Cyst Excision and Roux-en-Y Choledochojejunostomy in Adults
Published on: February 28, 2025
[Laparoscopic choledocho-duodenostomy]
Akos Botos1, János Bezsilla, Sándor Bende
1Sebeszeti Osztály. akos.botos@mst.hu
Magyar Sebeszet
|April 17, 2007
Summary
Laparoscopic common bile duct exploration effectively treats jaundice from stones. In select cases, laparoscopic choledocho-duodenostomy offers a safe biliary diversion for elderly or frail patients.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
- Minimally Invasive Surgery
Background:
- Laparoscopic common bile duct exploration is standard for obstructive jaundice due to ductal calculi.
- Periampullary lesions may require endoscopic stenting or biliodigestive diversion, often via laparotomy due to laparoscopic anastomosis challenges.
Observation:
- A 76-year-old patient with obstructive jaundice and biliary calculosis failed endoscopic treatment due to poor cooperation.
- Laparoscopic common bile duct exploration revealed ductal calculi and a papillary stricture.
Findings:
- Successful laparoscopic common bile duct exploration and extraction of calculi.
- A hand-sutured, side-to-side laparoscopic choledocho-duodenostomy was performed for permanent biliary diversion using absorbable sutures.
- The patient experienced an uneventful postoperative course with no follow-up complications.
Implications:
- Laparoscopic choledocho-duodenostomy is a safe and feasible procedure in selected cases.
- This laparoscopic approach offers significant advantages for elderly patients and those in poor general condition.
- It expands the utility of minimally invasive surgery for complex biliary conditions.
