Effectiveness of Cholecystostomy for Cholelithiasis after Billroth II Reconstruction—Report of a Case—

Abstract

A 94-year-old male patient was diagnosed as having choledocholithiasis and cholecystolithiasis, with dilatation of the common bile duct and gallbladder. At first, we tried PTGBD, as we considered that ERCP would be difficult in this patient because of the surgically altered anatomy. However, we could not insert the tube. Then, we performed a mini-laparotomic cholecystostomy. As the jaundice was successfully controlled, we performed elective endoscopic lithotripsy and laparoscopic cholecystostomy.

Endoscopic biliary drainage is the treatment of first choice for patients needing biliary drainage. Percutaneous transhepatic biliary drainage becomes necessary when endoscopic biliary drainage cannot be accomplished. On the other hand, surgical biliary drainage is rarely required. When both endoscopic biliary drainage and percutaneous transhepatic biliary drainage prove impossible, cholecystostomy could be an effective alternative that may be worth considering.