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Intrahepatic gallstones. A case report
Summary
This case study details a patient with acute cholecystitis and retained gallstones. Surgical attempts to remove intrahepatic stones failed, leading to biliary enteric drainage.
Area of Science:
- Gastroenterology
- Surgical Gastroenterology
- Hepatobiliary Surgery
Background:
- Acute cholecystitis presents with abdominal pain, nausea, and vomiting.
- Biliary imaging, such as technetium-99m scans, confirms gallbladder inflammation.
- Pigment stones in the common bile duct require prompt management.
Observation:
- A patient presented with symptoms of acute cholecystitis.
- Inflamed gallbladder and common bile duct stones were identified.
- Numerous retained gallstones were found in the right hepatic duct radicles.
Findings:
- Standard and extended choledochotomy failed to remove intrahepatic gallstones.
- Saline flushing was ineffective in dislodging retained stones.
- Choledochoduodenostomy successfully established biliary enteric drainage.
Implications:
- Complex intrahepatic gallstone removal poses significant surgical challenges.
- Biliary enteric drainage offers a palliative solution when stone extraction is not feasible.
- Effective management of retained gallstones is crucial for preventing complications.