Tratamento laparoscópico de coledocolitíase / Laparoscopic treatment of comon bile duct lithiasis
Arq. gastroenterol
; 37(3): 183-6, jul.-set. 2000. ilus
Article
em Pt
| LILACS
| ID: lil-279402
Biblioteca responsável:
BR1.1
RESUMO
With the advances of videolaparoscopic surgery, this approach had become the treatment of choice for cholelithiasis. However, about 5 per cent to 10 per cent may present common bile duct lithiasis. Most surgeons have still difficulties to deal with this situation and do prefer resolve with open surgery or with further endoscopic approach. We present a case of a 60-year-old man, with 18 months history of right upper quadrant pain, weight loss and jaundice. He was referred with diagnostic of pancreatic cancer. Laboratory investigation showed increased bilirubin (10 mg/dL), alkaline phosphatase and GGT. Abdominal ultrasound showed atrophic gallbladder with dilated intra and extrahepatic biliary tree. Computerized tomography scan disclosed enlarged biliary tree with 3 cm stone in the distal common bile duct. The patient underwent a laparoscopic cholecystectomy followed by choledochotomy and retrieval of the large stone. A latero-lateral choledochoduodenum anastomosis was then performed to decompress the biliary tree. The patient had an uneventful recovery being discharged at the 6th postoperative day. Laparoscopic management of choledocholithiasis is feasible in many patients, specially those with dilated biliary tree. The retrieval of stones may be followed by biliary drainage with T-tube. In some elderly patients with chronically dilated common bile duct, as in the present case, a choledochoduodenal anastomosis is the procedure of choice
Texto completo:
1
Base de dados:
LILACS
Assunto principal:
Cálculos Biliares
/
Colecistectomia Laparoscópica
/
Cirurgia Vídeoassistida
Limite:
Humans
/
Male
Idioma:
Pt
Revista:
Arq. gastroenterol
Assunto da revista:
GASTROENTEROLOGIA
Ano de publicação:
2000
Tipo de documento:
Article
País de afiliação:
Brasil