PTCD and choledochoscopy for recurrent choledocholithiasis after multiple abdominal surgeries: a case report.

Area of Science:

• Gastroenterology
• Surgical Innovation

Background:

• Intra-abdominal adhesions are a concern for patients with prior open cholecystectomy or abdominal surgery.
• Recurrent common bile duct stones pose a challenge, especially in patients with a history of multiple abdominal procedures.

Observation:

• A 68-year-old male with a history of open Billroth II surgery and open cholecystectomy presented with recurrent common bile duct stones and cholangitis.
• The patient had previously undergone successful gamma knife treatment for gastric cancer brain metastasis.

Findings:

• Percutaneous transhepatic cholangiodrainage (PTCD) combined with choledochoscopic stone extraction successfully removed common bile duct stones in a patient with extensive surgical history.
• The procedure was completed with complete stone removal and placement of a postoperative PTCD tube.

Implications:

• PTCD offers advantages for patients with multiple abdominal surgeries, including shorter operative times, reduced blood loss, and quicker recovery.
• This minimally invasive technique facilitates earlier resumption of eating and ventilation, minimizing patient trauma.