[Dissolution of choledochus stones with heparin-saline solution]

Area of Science:

• Gastroenterology and Hepatobiliary Surgery

Background:

• Cholecystectomy is a common surgical procedure.
• Bile duct stones can be a complication following cholecystectomy, necessitating further intervention.

Observation:

• In 336 cholecystectomies, 18% required bile duct revision.
• Six patients (1.8%) had residual bile duct stones detected postoperatively.
• These stones ranged from one to three per patient.

Findings:

• Three patients with residual stones underwent successful reoperation.
• Three patients were treated with heparin solution irrigation.
• Two patients treated with heparin experienced stone dissolution in 13 and 20 days.
• One patient required reoperation due to septic fever and removal of decayed material.
• All patients achieved complication-free recovery.

Implications:

• Non-operative management with heparin irrigation is a viable option for select cases of residual bile duct stones.
• Early detection and management of postoperative bile duct stones improve patient outcomes.
• Minimally invasive techniques can reduce the need for repeat surgical interventions.