Giorgio Dalmonte1, Marina Valente2, Simone Bosi3, Alessandro Gnocchi3, Federico Marchesi2. 1. Unit of Clinical Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy. g.dalmonte86@gmail.com. 2. Unit of Clinical Surgery, Department of Medicine and Surgery, Parma University Hospital, Parma, Italy. 3. S.C. Gastroenterologia ed Endoscopia Digestiva, Parma University Hospital, Parma, Italy.
Abstract
INTRODUCTION: In Roux-en-Y reconstructions, choledocholithiasis could represent a really challenging condition to treat which can be treated by a surgical-assisted ERCP. Only six cases of transjejunal laparoscopic-assisted ERCP (LAERCP) can be found in literature to date and no large series are present. METHODS: A young woman who had undergone a laparoscopic Roux-en-Y gastric bypass 2 years earlier came complaining recurrent abdominal pain. Radiologic exams found stones in the common bile duct and no signs of internal hernia. We therefore decided to perform a transjejunal LAERCP finding a concomitant internal hernia in the Petersen's space which was repaired at the same time. RESULTS: The post-operative course was uneventful. CONCLUSION: Transjejunal LAERCP is a feasible technique to deal with choledocholithiasis, and it allows at the same time to identify and treat concomitant conditions like internal hernias.
INTRODUCTION: In Roux-en-Y reconstructions, choledocholithiasis could represent a really challenging condition to treat which can be treated by a surgical-assisted ERCP. Only six cases of transjejunal laparoscopic-assisted ERCP (LAERCP) can be found in literature to date and no large series are present. METHODS: A young woman who had undergone a laparoscopic Roux-en-Y gastric bypass 2 years earlier came complaining recurrent abdominal pain. Radiologic exams found stones in the common bile duct and no signs of internal hernia. We therefore decided to perform a transjejunal LAERCP finding a concomitant internal hernia in the Petersen's space which was repaired at the same time. RESULTS: The post-operative course was uneventful. CONCLUSION: Transjejunal LAERCP is a feasible technique to deal with choledocholithiasis, and it allows at the same time to identify and treat concomitant conditions like internal hernias.