Benign stenosis of common bile duct after Roux Y gastrectomy

Česká verze

Authors: M. Piter ¹; J. Klein ^1,2; B. Tolmáči ¹; J. Maňák ³
Authors place of work: Chirurgické oddělení, Krajská nemocnice Tomáše Bati, Zlín ¹; Fakulta zdravotníctva, Trenčianská Univerzita Alexandera Dubčeka, Trenčín ²; III. interní gerontometabolická klinika Fakultní nemocnice Hradec Králové a Lékařská fakulta Univerzity Karlovy ³
Published in the journal: Rozhl. Chir., 2022, roč. 101, č. 7, s. 332-336.
Category: Kazuistika
doi: https://doi.org/10.33699/PIS.2022.101.7.332–336

Summary

We present the case of a 60-year-old patient with the history of subtotal gastric resection and reconstruction of passage using the Roux-Y loop, five years later diagnosed with benign stenosis of the common bile duct. The possibilities of using endoscopy and interventional radiology for the bile duct treatment in the postoperatively altered terrain of the proximal digestive tract were limited. After failure of these methods the patient was indicated for surgery – biliodigestive anastomosis. The postoperative course was significantly complicated by bleeding and formation of bile and colic fistulas. Over time, a migrated stent was found in the small intestine, which was the cause of inflammatory changes and incomplete small bowel obstruction. Increased intraluminal pressure in the intestinal loops inhibited healing of the anastomosis and was a major cause of the complications.

Keywords:

choledochoduodenostomy – biliocutaneous fistula – migrated transhepatic drain

Zdroje

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