The first successful experience of laparoscopic formation of choledochoduodenoanastomosis in choledocholithiasis and obstructive jaundice in the conditions of an interdistrict surgical center

Introduction. The development of laparoscopic methods for treating gallstone disease (GSD), especially such a form as choledocholithiasis, is a topical issue in modern surgery.
Objective. Analyze the treatment provided with a brief review of the literature.
Materials and methods. The data of instrumental and laboratory examinations are presented, as well as the results of surgical treatment of the patient for mechanical jaundice due to choledocholithiasis. In this case, a laparoscopic method of treatment was used, which consisted of cholecystectomy, choledochotomy with choledocholithoextraction and the formation of a side-to-side choledochoduodenoanastomosis.
Results. As a result of successful surgical treatment, the patient was quickly discharged for outpatient treatment without complications in the immediate observation period.
Discussion. Choledocholithiasis has a number of types of surgical treatment, while at the moment the «gold standard» is endoscopic papillosphincterotomy (EPST). Despite this, EPST has a number of limitations in application.
Conclusions. In case of impossibility of performing endoscopic papillosphincterotomy, the option choice may be laparoscopic formation of choledochoduodenoanastomosis with all the advantages of this minimally invasive method. This type of surgical intervention can be performed, including the level of the interdistrict surgical center.

1. Bajramov, N. Ju. Laparoskopicheskaja holedohoduodenostomija / N. Ju. Bajramov, N. A. Zejnalov, V. A. Pashazade // Hirurgija. Zhurnal im. N. I. Pirogova. – 2013. – № 1. – S. 43–46.

2. Gibridnye hirurgicheskie vmeshatel’stva v lechenii holangita i biliarnogo sepsisa na fone holecistoholedoholitiaza / D. N. Popov [et al.] // Vestnik hirurgii imeni I. I. Grekova. – 2019. – Vol. 178, № 3. – S. 34–38.

3. Opyt primenenija kombinirovannogo metoda “Randevu” pri vmeshatel‘stvah na distal‘nyh otdelah zhelchevyvodjashhih putej / R. R. Mudarisov [et al.] // Vestnik medicinskogo instituta “Reaviz”: reabilitacija, vrach i zdorov’e. – 2022. – Vol. 58, № 4. – S. 84–92.

4. Pavelec, K. V. Sovremennyj podhod k lecheniju holedoholitiaza / K. V. Pavelec, D. V. Gacko, D. S. Rusanov // Medicina: teorija i praktika. – 2018. – T. 3, № 3. – S. 27–33.

5. Sazhin, A. V. Ostryj appendicit / A. V. Sazhin, T. V. Nechaj, A. I. Kirienko. – M.: MIA, 2019. – 208 s.

6. Sravnitel’nyj analiz neposredstvennyh rezul’tatov laparoskopicheskoj i laparotomnoj holedoholitotomii / S. V. Tarasenko [et al.] // Jeksperimental’naja i klinicheskaja gastrojenterologija. – 2018. – Vol. 152, № 4. – S. 60–65.

7. Choledochoduodenostomy in Bile Duct Stone Diseases / M. R. Attri r [et al.] // Indian Journal of Surgery. – 2021. – Vol. 83. – P. 1506–1510.

8. Choledochoduodenostomy versus hepaticojejunostomy – a matched case–control analysis / А. Schreuder [et al.] // HPB: the official journal of the International Hepato Pancreato Biliary Association. – 2021. – Vol. 23, iss. 4. – P. 560–565.

9. Clinical spotlight review for the management of choledocholithiasis / SAGES Guidelines Committee: V. K. Narula, E. C. Fung, D. W. Overby, W. Richardson, D. Stefanidis // Surg Endosc. – 2020. – Vol. 34, № 4. – P. 1482–1491.

10. Comparative analysis of laparoscopic choledocholithiasis and ERCP treatment after cholecystectomy / J. Zhang, L. Li, Y. Jiang [et al.] // BMC Surgery. – 2023. – Vol. 23, № 1. – P. 304.

11. Epidemiology and outcomes of choledocholithiasis and cholangitis in the United States: trends and urbanrural variations / S. Li, L. Guizzetti, C. Ma [et al.] // BMC Gastroenterology. – 2023. – Vol. 23, № 1. – P. 254.

12. Global Epidemiology of Gallstones in the 21st Century: A Systematic Review and Meta-Analysis / Wang, Xin [et al.] // Clinical Gastroenterology and Hepatology. – 2024. – Vol. 22, iss. 8. – P. 1586–1595.

13. Harbhajan, Singh T. S. Laparoscopic choledochotomy and choledochoduodenostomy for the management of persistent common bile duct stones / T. S. Harbhajan Singh, S. Seang, S. P. Roy, A. Majid // SAGE Open Medical Case Reports. – 2022. – Vol. 10. – P. 1–5.

14. Laparoscopic Choledochoduodenostomy: One of Its Kind Operation for Common Bile Duct Stones / R. Pandit [et al.] // Civil Med Journal. – 2023. – Vol. 1, № 1. – Р.15–22.

15. Ng, B. Case report of choledocholithiasis 40 years post cholecystectomy / B. Ng // Radiol Case Reports. – 2024. – Vol. 19, № 4. – P. 1589–1591.

16. Second endoscopic retrograde cholangiopancreatography after failure of initial biliary cannulation: A single institution retrospective experience / X. Deng [et al.] // Exp Ther Med. – 2022. – Vol. 23, № 4. – Р. 297.

17. The Conservative Management of Choledocholithiasis With Ursodeoxycholic Acid / D. O. Oluboyede [et al.] // Сureus journal of medical science. – 2023. – Vol. 15, № 8. – P. e43850.