A CASE OF LAPAROSCOPIC CHOLEDOCHOLITHOTOMY IN A PATIENT WITH PREVIOUS LAPAROSCOPIC CHOLECYSTECTOMY AFTER SUBTOTAL GASTRECTOMY

Abstract

A case of laparoscopic choledocholithotomy in a patient with previous laparoscopic cholecystectomy after subtotal gastrectomy is reported. A 71-year-old man who had undergone subtotal gastrectomy with Billroth II reconstruction for duodenal ulcer was admitted due to acute cholecystitis. We conducted laparoscopic cholecystectomy after setting up the first trocar on near the right side of the navel with open laparotomy, another 3 trocars on the right upper quadrant of the abdomen under laparoscopic observation avoiding peritoneal adhesion. After trocar placement, adhesiolysis and Calot's triangle dissection were done. Cholecystectomy was completed by laparoscopy and the postoperative course was good. Eleven months after surgery, the patient was admitted with jaundice due to choledocholithiasis. We conducted laparoscopic choledocholithotomy with T-tube drainage and the patient had an uneventful recovery. Laparoscopic choledocholithotomy is thus feasible and effective in patients with previous laparoscopic cholecystectomy in ameliorating postoperative pain and shortening the hospital stay.