Surgical management of a patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis

Abstract

A clinical case of surgical management of patient with biliodigestive anastomosis stricture complicated by multiple intrahepatic lithiasis is presented. The patient was 57 years old woman. Anamnesis of the disease: in 2016, biliodigestive anastomosis was performed due to iatrogenic damage of the biliary tract. She was admitted to the hospital with complaints of the right upper abdomen pain, accompanied by chills, jaundice, and fever up to 39°C. The examination revealed a stricture of a previously formed biliodigestive anastomosis complicated by multiple intrahepatic cholelithiasis. Surgical intervention was performed: at the first stage – percutaneous transhepatic cholangiostomy; at the second stage – laparotomy, separation of hepaticojejunoanastomosis, intraoperative cholangioscopy with lithoextraction, resection of a small bowel section with a Brownian anastomosis, post-colon hepaticojejunostomy on a disconnected loop and replaceable transhepatic drains (Smith-Praden-Saypol-Kurian).