Lithiasis of the Main Biliary Tract: Epidemiological, Diagnostic and Therapeutic Features: Case Series Report

Main Article Content

A. El Karouachi
Y. Fakhri
M. Ouchan
S. R. El Jai
D. Erguibi
R. Boufettal
F. Chehab

Abstract

Common bile duct stones is a common condition that can regularly face any digestive surgeon.

Our goal is to study the diagnostic and therapeutic aspects of the common bile duct stones in digestive surgery department at the CHU IBN ROCHD CASABLANCA, then compare them to the literature, Through a retrospective study including 81 patients with common bile duct stones, during a 4-year period between 1 January 2014 and 31 January 2018.

The percentage of female was 76, while men accounted for only 23%, with an average age of 60 years with an increase in the frequency with age, reaching a max frequency between 50 and 80 years.

Hepatic colic, vomiting, fever, and jaundice are the most common clinical signs presented by the patients in this study. Biological cholestasis was detected in 52%, hepatic cytolysis in 38% of cases.

ultrasound was performed in 76 patients and confirmed it by showing the stones in the common bile duct in 38 patients.The bili-MRI was performed in 74 patients,confirmed a common bile duct stones in 63.

52 patients received a laparotomy, while 26 received a laparoscopy, and 3 patients received an endoscopic treatment. External biliary drainage was performed in 10 patients, an internal drainage in 51 patients. Postoperative complications have been noted in 2 cases, and one case of death.

The common bile duct exposes to serious risks such as acute cholangitis and acute pancreatitis, treatment is therefore imperative and urgent in front of any common bile duct stone to avoid these complications.

Keywords:
Lithiasis of the common bile duct, jaundice, surgery.

Article Details

How to Cite
Karouachi, A. E., Fakhri, Y., Ouchan, M., Jai, S. R. E., Erguibi, D., Boufettal, R., & Chehab, F. (2020). Lithiasis of the Main Biliary Tract: Epidemiological, Diagnostic and Therapeutic Features: Case Series Report. Asian Journal of Research in Surgery, 4(3), 7-14. Retrieved from https://journalajrs.com/index.php/AJRS/article/view/30134
Section
Case study

References

Muscari F, Delebecq T, Foppa B, Suc B. Management of choledocholithiasis. J Chir (Paris). 2006;143(3):148-54.

Martin DJ, Vernon DR, Toouli J. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev; 2006.

Dasari BV, Tan CJ, Gurusamy KS, Martin DJ, Kirk G, McKie L, Diamond T, Taylor MA. Surgical versus endoscopic treatment of bile duct stones. Cochrane Database Syst Rev; 2013.

Hugier M. Bornet P. Charpak Y. Houry S. Selective contraindications based on multivariate analysis for operative cholangiography in biliary lithiasis. Surg Gynecol Obstet. 1991;172:470-74.

Abarrah Khalid. LVBP à l’hopital AL Ghassani de Fés (66 cas opérés).Thèse de Médecine, rabat. 1994;243.

Moumen et Coll. Elfares F.LVBP à propos de 329 observations. Lyon chirurgical. 1997;87(3):280-282.

Buffet C, Jacquemin E, Erlinger S. Physiopathologie, épidémiologie et histoire naturelle de la lithiase de la lithiase biliaire. EMC Hépatologie. 2008;47:1-7.

Erlinger S. Physiopathologie et épidémiologie de la lithiase biliaire. EMC Hépatologie. 1996;4:10.

Franck Z, Angiocholite aigüe. Revue du praticien. 2007;57:2129-33.

Delsanto P, Kzarian K, Forbes J, Rogers P et al. Prediction of operative cholangiography in patients undergoing elective cholecystectomy with routine liver function chemistries. Surgery. 1995;98(1): 7-11.

Erlinger S. Biliary lithiasis. Gastro-entérologie Clinique et Biologique. 2002; 26:1018-25.

Grotemeyer KC, Lammert F. Gallstones – Causes, Consequences. Dtsch Med Wochenschr. 2016;141(23):1677-82.

Gallix B, Anfort S, Pierreddon M, Garibaldi F. Une angiocholite: Comment la reconnaitre? quelles conduite à tenir ?J radiol. 2006;87(4):430-40.

Chih-Wei. Can CT with coronal reconstruction improve the diagnostic of choledocolithiasis? Journal of Gastroenterology and Hepatology. 2008; 23:1586-89.

Filali A, et Coll. Profil épidémiologique et évolutif de la lithiase biliaire. Tunisie Méd. 1985;63:121-4.

Godchaux J. L’écho-endoscopie dans le diagnostic de la lithiase cholédocienne. Acta endoscopica. 2008;30(2):301-4.

Stiegmann GV. Goff JS. Mansour A. Pearlmann N. Precholecystectomy endoscopic cholangiography and stone removal is not superior tocholecystectomy, cholangiography and common bile duct exploration. Am J Surg. 1992;163:227-30.

Stain SC, Cohen H, Tsuishoysha M, Donovan AJ. Choledocholithiasis: Endo-scopic sphincterotmy or common bile duct exploration. Ann Surg. 1991;213:627-34.

Hammarstrm LE, Holmin T, Stridbeck H, Ihse I, Long term follow-up of a prospective randomized study of endoscopic versus surgical treatment of bile duct calculi in patients with gallbladder in situ. Br J Surg. 1995;82:1516-21.

Suc B, Escat J, Cherqui D, Surgery versus endoscopy as primary treatment in symptomatic patients with suspected common bile duct stones. A multicenter prospective randomized trial. Arch Surg. 1998;133:702-8.

Cuschieri A, Lezoche E, Morino M. E.A.E.S. multicenter prospective randomized trial comparing two stage versus single-stage mamagement of patients with gallstone disease and ductal calculi. Surg Endos. 1999;13:952-7.

Nathanson LK, O’Rourke NA, Martin IJ, Fielding GA. Postoperative ERCP versus Laparoscopic choledocototomy for clearance of selected bile duct calculi. A randomized trial. Ann Surg. 2005;242:188-92.

Rat P, Bernard A, Rousselet J, Favre J. La lithiase de la voie biliaire principale: Résultats de la chirurgie ouverte.Lyon chir. 1997;93:1-2.

Nardi et Coll.Lithiase de la voie biliaire principale.Traitement chirurgical reste licite chez le sujet âgé. Lyon Chir. 1992;88:381-84.

Houdart T, Lecomte P, Perniceni T, Salmeron M. Cent vingt-cinq cholédocoto-miesconsécutives. Etat actuel des complications de la chirurgie de la voie biliaire principale. Ann Chir. 1992;10:928-31.

Meyer C, Thiry L, Firtion O, Rohr S. Résultats de la chirurgie traditionnelle dans le traitement de la lithiase de la VBP: A propos de 670 cas.Lyon Chir. 1997;93:12-27.

Aube C. Apport de la radiologie dans le diagnostic de la LVBP. Revue française de gastroenterologie. 1994 ;30(296):391-93.