Case report of choledocholithiasis 40 years post cholecystectomy

Area of Science:

• Gastroenterology
• Hepatology
• Surgical Case Reports

Background:

• Cholecystectomy is a common surgical procedure.
• Delayed choledocholithiasis, especially decades post-surgery, is exceptionally rare.
• Understanding long-term complications of cholecystectomy is crucial for patient management.

Observation:

• A 72-year-old female presented with acute right upper quadrant pain and obstructive jaundice 40 years after open cholecystectomy.
• Imaging revealed a high burden of calculi within the common bile duct.
• Endoscopic retrograde cholangiopancreatography (ERCP) successfully retrieved the common bile duct stones.

Findings:

• This case represents one of the longest reported latency periods for choledocholithiasis post-cholecystectomy.
• Potential causes for delayed stone formation include retained surgical clips acting as a nidus, bile duct strictures, or other factors causing bile stasis.
• The patient's presentation underscores the possibility of late-onset biliary complications long after gallbladder removal.

Implications:

• This case adds to a limited body of literature on extremely delayed choledocholithiasis.
• Further research into the specific risk factors and mechanisms of late-onset common bile duct stone formation post-cholecystectomy is warranted.
• Highlights the importance of considering biliary stone disease even many years after gallbladder surgery.