Open bile duct exploration as a therapeutic solution for difficult to manage choledocholithiasis: a case report

Eduardo Poblano Olivares, Brenda Soto Perez, Jorge L. Olmos Gonzalez


The most common etiology of bile duct obstruction in patients with cholelithiasis is choledocholithiasis. The diagnosis of cholelithiasis is based on clinical suspicion and confirmed by ultrasound (US) of the liver and bile ducts. The management of bile duct lithiasis has evolved considerably and currently, ERCP is the most common and recommended technique. However, in cases of multiple lithiases, fragmentation of the lithiasis during extraction, excessive preoperative or transoperative handling of the ampullary region, previous stenosis of the ampullary region, juxtapapillary diverticula, primary bile duct stones, or residual intrahepatic stones, a large number of hospitals do not have sufficient resources to perform minimally invasive procedures and offer these therapeutic alternatives instead.



Choledocholithiasis, Bile duct exploration, Endoscopic retrograde cholangiopancreatography, Laparoscopic cholecystectomy

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