Date of Presentation
5-5-2022 12:00 AM
College
School of Osteopathic Medicine
Poster Abstract
Gallstones are a common prevalence in western societies where approximately 15% of Americans have gallstones. The mainstay treatment for symptomatic cholelithiasis is laparoscopic cholecystectomy. It is estimated approximately 650,000 to 700,000 cholecystectomies are performed every year. Most patients feel relief after a laparoscopic cholecystectomy, but a small number of patients experience post cholecystectomy syndrome, which presents as biliary colic pain. Although the pathophysiology of the post cholecystectomy syndrome is unclear, one theory proposes that it is due to the alteration in bile flow after the removal of the gallbladder, which serves as a reservoir for bile. This bile is thought to be the main trigger in patients with mild gastroduodenal symptoms or diarrhea. The lack of bile reservoir can furthermore create a nidus for de novo biliary stone formation, and can cause choledocholithiasis. There have been only a few case reports of post cholecystectomy bile duct stones occurring more than 10 years following surgery in literature. Most of these reports describe the presence of stones within the gallbladder/cystic duct remnant or secondary to migrating surgical clips. We report a suspected case of choledocholithiasis 20 years following open cholecystectomy secondary to a primary biliary stone.
Keywords
choledocholithiasis, Postcholecystectomy Syndrome, case reports
Disciplines
Digestive System | Digestive System Diseases | Gastroenterology | Medicine and Health Sciences
Document Type
Poster
A Case Report of Suspected Choledocholithiasis 20 Years After Cholecystectomy
Gallstones are a common prevalence in western societies where approximately 15% of Americans have gallstones. The mainstay treatment for symptomatic cholelithiasis is laparoscopic cholecystectomy. It is estimated approximately 650,000 to 700,000 cholecystectomies are performed every year. Most patients feel relief after a laparoscopic cholecystectomy, but a small number of patients experience post cholecystectomy syndrome, which presents as biliary colic pain. Although the pathophysiology of the post cholecystectomy syndrome is unclear, one theory proposes that it is due to the alteration in bile flow after the removal of the gallbladder, which serves as a reservoir for bile. This bile is thought to be the main trigger in patients with mild gastroduodenal symptoms or diarrhea. The lack of bile reservoir can furthermore create a nidus for de novo biliary stone formation, and can cause choledocholithiasis. There have been only a few case reports of post cholecystectomy bile duct stones occurring more than 10 years following surgery in literature. Most of these reports describe the presence of stones within the gallbladder/cystic duct remnant or secondary to migrating surgical clips. We report a suspected case of choledocholithiasis 20 years following open cholecystectomy secondary to a primary biliary stone.