Laparoscopic approach to anomalous connection between the choledochus and the pancreatic duct

• Published in: Progress of Digestive Endoscopy(1972) Vol. 57; no. 2; pp. 75 - 79
• Main Authors: Murai, Shinji, Motogami, Kenta, Fujita, Kouji, Handa, Shinnichi, Nakamura, Akihiko, Yamauchi, Hideo, Matsui, Junichi, Amemiya, Tetsu
• Format: Journal Article
• Language: Japanese; English
• Published: Japan Gastroenterological Endoscopy Society Kanto Chapter 15.11.2000
• ISSN: 0389-9403; 2189-0021; 0389-9403
• DOI: 10.11641/pdensks.57.2_75

Case 1 : A 30-year-old woman visited the hospital for the chief complaint of pain in the right hypochondrium. After close examination, pancreatic-duct-biliary-tract confluence disorder associated with cystic dilatation of the common bile duco was diagnosed. The dilated portion of the common bile duct was subsequently resected under a laparoscope, and common-hepatic-duct-duodenum anastomosis was performed. Case 2 : A 53-year-old woman visited a local clinic for the chief complaint of upper abdominal pain, where US examination revealed a polyp of gallbladder, and she was referred to our hospital. US and EUS examinations revealed protruded lesions (maximum ta) in the gallbladder, which had a maximum diameter of 25 mm. ERCP revealed coexisting confluence disorder of the pancreatic duct and biliary tract without dilatation of the common bile duct. Laparoscopic cholecystectomy was performed, and after identifying a benign tumor by intraoperative rapid examination, laparoscopic choledochectomy, and common-hepatic-duct-duodenum anastomosis were performed. In case 1 and 2, surgery was performed completely under the guidance of a laparoscope, and the patients began to take food 5 days after the procedure, and were discharged 10 days post-operatively. The mean length of surgery was 7 hours 31 minutes. Therefore, this method of surgery, which allows postoperative endoscopic follow-up, can be an excellent and less invasive treatment for pancreatic-duct-biliary-tract confluence disorder, if cases are selected according to indication to this therapy.