A 35-year-old male, operated in 2001 for morbid obesity (Scopinaro technique) by laparotomy.
In May 2011, the patient was admitted to the hospital with severe acute cholangitis, fever of 38.5°C, jaundice and severe epigastric pain and right hypochondrium.
Ultrasound and computed tomography showed multiple cholelithiasis.
Due to previous gastrectomy, we performed laparoscopically assisted ERCP.
Through an exchange of 15 mm Ø, placed by the surgeon directly at the level of the Treitz angle, a conventional gastrater (Olympus GIF-Q165Ø papilla) was advanced to reach the gallbladder,
The main bile duct was cannulated selectively and deeply.
The common bile duct was dilated, with a caliber of 15 mm Ø, and was completely occupied by multiple filling defects, the most distal of about 10 mm Ø.
We performed a biliary sphincterotomy in the opposite direction, using a Soehendra papillotome for Billroth II (C, PTG-20-6-BIING).
Finally, using a balloon of 12-15 mm OØ (Boston Scientific; Extra Restricted lasheval), Foston Scientific (Boston Scientific) was extracted between 10 and 12 calculi, similar to those obtained.
