Abstract

FRANCO CHAVEZ, Luz Janina; GIMENEZ, Mara Sofía; OVELAR, Araceli  and  ZARACHO, Juan Carlos. Surgical treatment of coledocholithiasis not resolved by endoscopic papillotomy at Instituto de Previsión Social - Ingavi, period 2022 - 2024. Cir. parag. [online]. 2025, vol.49, n.2, pp.18-20. ISSN 2307-0420.  https://doi.org/10.18004/sopaci.2025.agosto.18.

Introduction: Common bile duct stones are resolved by endoscopic retrograde cholangiopancreatography (ERCP) in 90% of cases. Currently, several therapeutic options are described for cases that fail ERCP, with the laparoscopic surgery is often the preferred approach. Objective: To describe the surgical treatment instituted in patients with choledocholithiasis not resolved by endoscopic papillotomy between January 2022 and December 2024 at the Social Security Institute, Ingavi. Materials and methods: An observational, descriptive, retrospective, cross-sectional study. Results: A total of 56 patients were included, of whom 25% had undergone cholecystectomies. The most frequent causes of failed ERCP were disproportion between the proximal and distal portion of the main bile duct in 33.9% of cases, and stones greater than 1 cm in diameter were found in 30.3% of cases. 7.1% of the cases were resolved by videolaparoscopy. In the conventional approach, choledochotomy with T-tube placement was the most common, at 46.1%, followed by biliodigestive diversion in 36.5% of cases. Conclusion: The surgical treatment of choice was the conventional approach with Kehr's T-shaped insert.

Keywords : Choledocholithiasis; Endoscopic Retrograde Cholangiopancreatography; Cholecystectomy.

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