An unusual cause of delayed presentation of laparoscopic common bile duct injury.
We describe an unusual case of a laparoscopic common bile duct (CBD) injury that presented with cholangitis 2 years after an apparently uneventful laparoscopic cholecystectomy. Preoperative ultrasound and endoscopic retrograde cholangiography suggested choledocholithiasis, showing proximal and intrahepatic duct dilatation with an inability to relieve the obstruction. At surgery, a lateral injury of the CBD wall with partial wall loss was found, adherent to an amorphous pigmented mass with the appearance of a knitted fabric causing CBD obstruction. The CBD was successfully reconstructed with a Roux-en-Y end-to-side hepaticojejunostomy, where the end of the Roux loop was anastomosed to the lateral CBD defect.
Karayiannakis
A J
AJ
Second Department of Surgery, Democritus University of Thrace, Medical School, 6 I. Kaviri Street, 68 100 Alexandroupolis, Greece. akarayan@usa.net
Polychronidis
A
A
Simopoulos
C
C
D000368:Aged; D000713:Anastomosis, Roux-en-Y; D002761:Cholangitis / Q000209:etiology; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003135:Common Bile Duct / Q000293:injuries*; D005260:Female; D006801:Humans; D012086:Reoperation