title: Management of intrahepatic biliary lithiasis after pancreatic cancer surgery.
abstract: Intrahepatic biliary lithiasis is fairly rare in western countries. In the case described here, liver stones had developed as a late consequence of biliary derivative surgery, which is well known to lead to this complication. However, this case is unusual because people who have undergone radical surgery for cancer of the head of the pancreas seldom survive long enough for liver stones to develop. Treatment for this 65-year-old woman, previously submitted to duodeno-cephalopancreatectomy, involved percutaneous balloon bilioplasty, with several passages in order to open the anastomosis. We then positioned two inner-outer biliary drains, through which repeated lavages were done. Finally, the patient underwent laser lithotripsy of the intrahepatic calculi and the fragments were cleared using a Dormia basket. Repeated cholangiographic monitoring showed progressively fewer stones, until the intrahepatic biliary tree was finally completely clear 120 days after the initial diagnosis. At the last follow-up, the patient was healthy, with normal blood values, considering her overall condition.
authors.affiliation: U.O. Chirurgia Generale "V. Bonomo", Università degli Studi di Bari.
authors.forename: Angela
authors.initials: A
authors.lastname: Pezzolla
authors.forename: Serafina
authors.initials: S
authors.lastname: Lattarulo
authors.forename: Giuseppe Massimiliano
authors.initials: GM
authors.lastname: De Luca
authors.forename: Gianluca
authors.initials: G
authors.lastname: Borrello
authors.forename: Fabio
authors.initials: F
authors.lastname: Fucilli
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Marano
authors.forename: Gennaro
authors.initials: G
authors.lastname: Fabiano
authors.forename: Nicola
authors.initials: N
authors.lastname: Palasciano
mesh_terms: D000368:Aged; D001653:Bile Ducts, Intrahepatic; D002758:Cholangiography; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000628:therapy*; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D017602:Lithotripsy, Laser; D010190:Pancreatic Neoplasms / Q000601:surgery*; D016577:Pancreaticoduodenectomy; D011183:Postoperative Complications; D013997:Time Factors; D016896:Treatment Outcome