BACKGROUND:Choledocholithiasis treatment is still a controversial topic, being done either with endoscopic retrograde cholangiopancreatography before laparoscopic cholecystectomy or by the use of laparoscopic cholecystectomy and exploration of common bile duct. According to literature, there is an unsuccessful rate of 6% when utilizing pre-operative endoscopic retrograde cholangiopancreatography. AIM: To report a case of a patient who underwent intraoperative CPRE as a solution to choledocholithiasis treated unsuccessfully by CPRE. CASE REPORT:- We present a case report of a 45-year-old patient, female, who was admitted to an emergency room with abdominal pain in the epigastrius and right hypochondrium. Ultrasonography showed choledocholithiasis, and the patient was indicated to a pre-operative endoscopic retrograde cholangiopancreatography, by which the catheterization of papilla was unsuccessful. The patient was then, submitted to a laparoscopic cholecystectomy and exploration of the common bile ducts by preoperative and intraoperative endoscopic retrograde cholangiopancreatography with the catheterization of papilla being guided by a guiding thread which was introduced through the cystic duct. A duodenoscopy with the capture of the guiding thread was performed, allowing the passage of papillotome, giving sequence to the preoperative endoscopic retrograde cholangiopancreatography, by which gallstones were removed. The patient had a satisfying recovery being discharged on the second post-operative day. CONCLUSION: In this case, the choledocholithiasis management by intraoperative endoscopic retrograde cholangiopancreatography with laparoscopic cholecystectomy was considered both safe and effective.
Choledocholithiasis; Cholangiopancreatography, endoscopic retrograde; cholecystectomy, Laparoscopic; Abdominal pain
