title: Successful treatment of limy bile syndrome extending to the common bile duct by laparoscopic cholecystectomy and common bile duct exploration: A case report and literature review.
abstract: Limy bile syndrome extending to the common bile duct (CBD) is a rare condition that lacks a standardized treatment. Laparoscopic cholecystectomy with laparoscopic choledocholithotomy by CBD exploration is preferred because it preserves the function of the sphincter of the Vater's papilla and allows treatment of both lesions. A 37-year-old man who was receiving entecavir for chronic hepatitis B developed right upper quadrant pain. Abdominal ultrasonography revealed a calcified shadow in the gallbladder and CBD. Abdominal imaging revealed a liquid-like material identified by a calcified shadow in two phases separated by a fluid-fluid level. Abdominal and 3-D drip infusion cholangiography CT showed stones in the gallbladder and CBD with limy bile. The patient underwent laparoscopic cholecystectomy and choledocholithotomy. Intraoperatively, white-yellow-colored bile and stones were drained from the CBD. A C-tube was placed. Postoperatively, remnant stones and radiopaque materials were absent. The stones comprised of >95% calcium carbonate.
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Masuda
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Mizuguchi
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Kanda
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Hiroyasu
authors.initials: H
authors.lastname: Furuki
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Mamada
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Taniai
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nakamura
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Yoshioka
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Matsushita
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Kawano
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Gastrointestinal and Hepato-Biliary-Pancreatic Surgery, Nippon Medical School Hospital, Tokyo, Japan.
authors.forename: Eiji
authors.initials: E
authors.lastname: Uchida
mesh_terms: D000328:Adult; D001646:Bile; D017081:Cholecystectomy, Laparoscopic; D042883:Choledocholithiasis / Q000473:pathology / Q000601:surgery*; D003135:Common Bile Duct / Q000601:surgery*; D042882:Gallstones / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D013577:Syndrome
keywords: Choledocholithiasis; laparoscopic common bile duct exploration; limy bile syndrome