Management of Common Bile Duct Stone Late after Laparoscopic Roux-en-Y Gastric Bypass for Obesity

Abstract

Rapid weight loss following Roux-en-Y gastric bypass (RYGBP) for the treatment of obesity can increase the incidence of cholelithiasis formation. Nevertheless, routine simultaneous cholecystectomy at the time of bariatric surgery remains controversial. However, in case of delayed occurrence of common bile duct (CBD) stones, the difficulty to reach endoscopically the biliary tract after RYGBP should be kept in mind.

We here report the case of a patient who presented with CBD stones seven years after gastric banding followed five years later by RYGBP without associated cholecystectomy.

Our approach of transgastric laparoscopic assisted endoscopic retrograde cholangiopancreatography followed by sphincterotomy and balloon stones extraction is illustrated.

Key words:

• Roux-en-Y gastric bypass
• common bile duct stone
• ERCP-laparoscopic surgery
• obesity surgery.

Additional information

Notes on contributors

V. Malherbe

V. Malherbe, M.D. Department of Surgery UCL Mont-Godinne Hospital 5530 Yvoir, Belgium Tel.: [phone] Fax: [phone] E-mail: [email protected]