The efficacy of double-balloon enteroscopy for intrahepatic bile duct stones after Roux-en-Y hepaticojejunostomy for choledochal cysts

Pediatr Surg Int. 2013 Nov;29(11):1103-7. doi: 10.1007/s00383-013-3376-7.

Abstract

Introduction: Intrahepatic bile duct (IHBD) stones are one of the most complicated morbidities that occur after Roux-en-Y hepaticojejunostomy (RYH); however, the optimal therapeutic approach is controversial.

Methods: Double-balloon enteroscopy (DBE) has been widely and frequently performed even in pediatric patients. We herein report the successful management of IHBD stones by biliary lithotripsy using DBE after RYH for a choledochal cyst (CC). DBE has made it possible to perform endoscopic therapeutic intervention, including balloon dilatation of an anastomotic stricture and removal of IHBD stones, without any major complications.

Conclusion: DBE is a less invasive and safe treatment method for IHBD stones in pediatric patients, which is capable of reaching the bilioenteric anastomosis after RYH for CC.

Publication types

  • Case Reports

MeSH terms

  • Anastomosis, Roux-en-Y / adverse effects
  • Bile Ducts, Intrahepatic*
  • Child
  • Cholangiopancreatography, Endoscopic Retrograde
  • Choledochal Cyst / diagnosis
  • Choledochal Cyst / surgery*
  • Cholelithiasis / diagnosis
  • Cholelithiasis / etiology
  • Cholelithiasis / surgery*
  • Double-Balloon Enteroscopy / methods*
  • Follow-Up Studies
  • Humans
  • Jejunum / surgery*
  • Liver / surgery*
  • Male
  • Postoperative Complications / diagnosis
  • Postoperative Complications / etiology
  • Postoperative Complications / surgery*