{Reference Type}: Case Reports
{Title}: Obstructive lithiasis of the lower bile duct discovered four decades after cholecystectomy and its management by ideal choledochotomy: a case report.
{Author}: Kamla JI;Bang GA;Tochie JN;Tchuenkam LW;Essomba AG;
{Journal}: J Med Case Rep
{Volume}: 17
{Issue}: 1
{Year}: 2023 Jul 24
暂无{DOI}: 10.1186/s13256-023-04052-3
{Abstract}: <B>BACKGROUND: </B>Residual lithiasis is the presence of stones in the common bile duct, ignored after one or more biliary interventions. We report an atypical case of chronic symptomatic lithiasis of the lower bile duct occurring 41 years after biliary surgery, managed successfully by ideal choledochotomy.<BR><B>METHODS: </B>A 68-year-old Black African female with several past laparotomies including a cholecystectomy forty-one years ago presented with hepatic colic-type pain that had been intermittent for several years but worsened recently. Her clinical, biological, and imaging test assessments were suggestive of a residual obstructive lithiasis of the lower common bile duct. Through an open right subcostal laparotomy approach, a dilated bile duct of approximately 3 cm was found and managed by transverse choledochotomy in which the stone was extracted in retrograde manner. After confirmation of disobstruction, a primitive bile duct suture without biliary drainage was performed and a tubular drain was positioned under the liver. The postoperative course was uneventful at follow-up of 30 days.<BR><B>CONCLUSIONS: </B>Residual choledocholithiasis can be avoided. We performed an ideal choledochotomy, of which the follow-up was simple.