
Robotic-assisted laparoscopic common bile duct exploration with hepaticojejunostomy for primary ductal stones in nonagenarians: A report of two cases
Author(s) -
Vivyan Wei Yen Tay,
Zhongkai Wang,
Brian K. P. Goh
Publication year - 2020
Publication title -
journal of minimal access surgery
Language(s) - English
Resource type - Journals
eISSN - 0972-9941
pISSN - 1998-3921
DOI - 10.4103/jmas.jmas_295_19
Subject(s) - medicine , ectasia , endoscopic retrograde cholangiopancreatography , common bile duct , bile duct , surgery , general surgery , pancreatitis
Experience with complex robotic-assisted laparoscopic (RAL) hepatobiliary and pancreatic (HPB) surgery remains limited to few tertiary institutions worldwide. In this report, we focus on biliary bypass surgery, one of the more complex HPB surgeries. Over the past few decades, the laparoscopic approach has gained preference over the open approach, but the robotic approach is still uncommon. Biliary bypass is also not often performed in nonagenarians due to its inherent-associated morbidity and mortality, and these patients typically have higher surgical risks. We present two cases of nonagenarians who had recurrent episodes of cholangitis secondary to multiple primary common bile duct (CBD) stones and ectatic bile ducts. Both the patients were treated conservatively over many years with repeated endoscopic retrograde cholangiopancreatography and stentings. They eventually presented to us and underwent successful RAL CBD exploration with hepaticojejunostomy.