Approach Duodenostomy for CBD stone after ERCP with T tube

Vandra Prinosa, M. Iqbal Rivai

Departement of Surgery, Faculty of Medicine Andalas/ M. Djamil Hospital Padang

Introduction
Jaundice is change in the color of the skin, eyes, or mucous membrane tissue that turns yellow
due to increased levels of bilirubin in the blood. One of the extra hepatic obstructive jaundice
caused by the common bile duct (CBD) stone. CBD stone can be as a primary process in the duct
of the coleducus, but the stone can also be a secondary stone that comes from the gallbladder and
then passes through the cystic duct and becomes a stone in the common bile duct. Duodenostomy
is rarely performed, but it can be done in cases of extrahepatic obstructive jaundice ec large CBD
stones
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Case report
A woman , 52-year-old woman came to M.Djamil hospital with complaints of jaundice all of the
body since 3 weeks ago, the patient had a history of extra hepatic obstructive jaundice ec CBD
stone 2 months ago had ERCP found large CBD stone, then explored CBD and T Tube. At
clinical examination conjungtiva was anemic, abdomen was jaundice and T tube inserted.
Bilirubin direct 7,3 mg/dl, total bilirubin 8,3 mg/dl. From cholangiografi showed dilated of bile
duct extrahepatal ec CBD stone. Patient was performed duodenostomy for stone evacuation.

Conclusion
Management in patients with CBD stones is often done by endoscopic, but it is also possible to do an
duodenostomy for large CBD stone. Delay in diagnosis and management can cause complications
such as cholangitis

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