Abstract
Bariatric patients are at risk for developing biliary stones. Choledocholithiasis poses a significant challenge in Roux-en-Y gastric bypass patients due to anatomical changes, complicating the treatment. We present a case of a 71-year-old female with recurrent choledocholithiasis post-bariatric surgery. After failed endoscopic attempts, a biliodigestive bypass with choledocoduodenal anastomosis was performed successfully using the Da Vinci robotic platform. This technique offers a single anastomosis, excluding the duodenum from transit, preventing food reflux. The patient had an uneventful recovery with no recurrence after 1 year. The choledocoduodenal anastomosis is a viable option for biliary diversion in patients with challenging endoscopic access post-gastric bypass, offering favorable outcomes.
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No datasets were generated or analysed during the current study.
Reference
Tustumi F, Pinheiro Filho JEL, Stolzemburg LCP, et al. Management of biliary stones in bariatric surgery. Ther Adv Gastrointest Endosc. 2022;19(15):26317745221105090. https://doi.org/10.1177/26317745221105087.
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Key Points
• Choledocholithiasis poses a major challenge in Roux-en-Y gastric bypass or biliopancreatic diversion patients due to anatomical changes, complicating diagnosis and treatment.
• A choledocoduodenal anastomosis is a viable option for biliary diversion in patients with a history of gastric bypass since the gastric bypass prevents food passage through the biliary anastomosis.
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Ribeiro, T.C., Charruf, A.Z., Stolzemburg, L.C.P. et al. Choledocoduodenal Biliary Bypass for Recurrent Choledocholithiasis in a Patient with Gastric Bypass: An Old Trick to Solve a Modern Problem. OBES SURG 34, 2280–2281 (2024). https://doi.org/10.1007/s11695-024-07251-z
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DOI: https://doi.org/10.1007/s11695-024-07251-z