Choledocholithiasis after gastric bypass: A growing problem

摘要

In their manuscript, DuCoin et al. address an important and growing problem, namely, access to and treatment of common bile duct stones in patients with Roux-en-Y reconstructions. Roux-en-Y gastric bypass (RYGB) comprises half of all weight loss procedures performed in the United States [1]. Given the current rate of approximately 100,000-200,000 bariattic procedures/year, an additional 500,000 to 1 million Americans/decade, who are at higher-than-average risk for symptomatic gallstones, will have access to their biliary trees complicated by surgically altered anatomy. The authors offer a single center's experience with a laparoscopic approach to internal drainage for choledocholithiasis after gastric bypass. While their approach represents an interesting option, it is not likely to be the first choice for treatment of choledocholithiasis in Roux-en-Y patients by a majority of surgeons.