Surgical Treatment of a Dormia Probe Embedded in the Choledochus, a Very Rare Complication: A Case Report

Abstract

Conventional treatment of main bile duct (MBD) lithiasis consists of endoscopic sphincterotomy followed by balloon and/or Dormia loop extraction of the stone(s). Several risk factors are known to contribute to the failure of stone extraction from the main bile duct. Probably the most important factor is stone size greater than 15 mm, or when the diameter of the lower part of the VBP is less than that of the stone, where care must be taken not to impact the stone in the sphincter of Oddi or in the Dormia, so as not to compromise the subsequent extraction. Among the complications linked to the use of the Dormia probe, biliary wounds are a well-known problem for surgeons, but lesions specifically linked to the use of the probe are less well known and appear to be underestimated. We report a case in which the Dormia catheter remained embedded in the common bile duct around a calculus, which itself remained attached without the possibility of removing it after endoscopic exploration, in a 72-year-old patient with lithiasis angiocholitis. Angiocholitis, requiring surgical extraction by choledochotomy. The rarity of this phenomenon leads us to discuss the causes and surgical management.