Korean J Gastroenterol.  2024 May;83(5):200-204. 10.4166/kjg.2023.148.

Surgical Removal of a Huge Common Bile Duct Stone

• Han JH
• So H
• Bang SJ
• Nah YW

• KMID: 2555973
• DOI: http://doi.org/10.4166/kjg.2023.148

Abstract

A 65-year-old woman was diagnosed with an 8 cm large common bile duct stone and multiple stones in both intrahepatic ducts because of abnormal liver function tests. After a multidisciplinary approach, surgical removal was considered, and primary closure after laparoscopic removal of the common bile duct stone was performed. The patient recovered without complications and was discharged on the fourth postoperative day. Endoscopic removal of common bile duct stones is the standard treatment, but surgical removal through laparoscopic common bile duct exploration is also a safe and effective treatment method for such huge gallstones.

Keyword

Choledocholithiasis; Laparoscopic surgical procedure; Cholangiopancreatography, endoscopic retrograde; Choledochojejunostomy

Figure

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  Fig. 1 Radiology findings. (A, B) CT and MR cholangiography shows huge CBD stone (arrowhead) and intrahepatic bile duct dilatation. (C, D) MRCP shows multiple intrahepatic bile duct stones in both lobes (arrow). CT, computed tomography; MR, magnetic resonance; CBD, common bile duct; MRCP, magnetic resonance cholangiopancreatography.

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  Fig. 2 Site and size of the trocars in laparoscopic common bile duct exploration.

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  Fig. 3 Findings and procedures of operation. (A) Dilatation of CBD resulting from a huge CBD stone. (B) After extraction of a huge CBD stone from CBD. (C) The dilated CBD is opened with a longitudinal incision. (D) CBD after primary closure. (E) Gross specimen of the huge CBD stone. CBD, common bile duct.

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  Fig. 4 Findings of the choledochoscope: no remnant bile duct stone in both intrahepatic ducts.

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