Laparoscopic choledochotomy and choledochoduodenostomy for the management of persistent common bile duct stones

Abstract

Choledochotomy and choledochoduodenostomy were commonly used technique in the early twentieth century to extract bile duct stones. Endoscopic retrograde cholangiopancreatography and sphincterotomy revolutionised the scenario and is currently the preferred first-line option for managing choledocholithiasis. However, in certain circumstances, where endoscopic retrograde cholangiopancreatography fails, choledochotomy and choledochoduodenostomy are the only available options. We present the case of an 86-year-old female with a background of multiple previous presentations with biliary sepsis and ascending cholangitis requiring multiple endoscopic retrograde cholangiopancreatographies that failed to remove all stones in the common bile duct. She underwent a laparoscopic choledochotomy and choledochoduodenostomy that successfully resolved her common bile duct obstruction. Laparoscopic choledochotomy and choledochoduodenostomy reduce the length of hospital stay and help to minimise complications associated with open surgery.