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ISSN 1561-3186 (Electronic)

2021, Number 1

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Rev Acta Médica 2021; 22 (1)

Surgical management of a large type B choledochocele in an adult

Zamora SO, Licea VM, Escobar RI, Palacios MIU, Rodríguez AMÁ

Language: Spanish
References: 15
Page:
PDF size: 140.16 Kb.


ABSTRACT

Introduction: Choledochocele is a very rare variety of choledochal cyst. It is the congenital dilation of the distal, intramural section of the bile duct. Being rare in adults, it affects four times more women than men. Regarding it genesis, the most widely accepted theory relates it to an anomalous union between the bile and pancreatic ducts that causes pancreatic juice reflux into the bile duct. Its management is currently endoscopic in most patients.
Objective: To present the surgical solution given to an adult diagnosed with a large type B choledochocele impossible to be treated endoscopically.
Case presentation: 41-year-old female, previously cholecystectomized for vesicular lithiasis, with abdominal pain in the epigastrium and right hypochondrium of months of evolution. Imaging studies showed a large saccular dilatation with stones, appearing in the second-third duodenal section, with suspicion of choledochocele. Surgical resection was performed by means of anterior duodenotomy, opening the mucosa of the posterior duodenal wall and through choledochocele resection. The extrahepatic bile duct was cannulated through Choledochotomy, in order to protect the integrity of the distal bile duct. The patient evolved without complications.
Conclusions: In choledochocele that cannot be treated endoscopically, especially large and with stones, the surgical management option is effective and safe, while the integrity of the distal bile duct is preserved.


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