Presentation
Epigastric pain for 3 days with jaundice and fever. Previous open cholecystectomy 40 years ago. Conjugated bilirubin: 91 umol/L.
Patient Data
Age: 70 years
Gender: Female
From the case:
Choledocholithiasis - 40 years post cholecystectomy
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A severely dilated biliary tree with a common bile duct measuring up to 32 mm in diameter and a high burden of calculi in the common bile duct.
The gallbladder is not visible due to a previous cholecystectomy.
Case Discussion
Choledocholithiasis post-cholecystectomy 40 years ago is a rare occurrence 1,2, even scarce, with such numerous calculi found in the common bile duct. An ERCP was performed, and a biliary sphincterotomy was done. A complete calculi removal was subsequently achieved by balloon extraction. A cholangiogram at the end of the procedure confirmed a clear duct.
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