Tag Archives: gallstones

General Surgery, Print Release

PUBLISHED: Robotic-Assisted Transcystic Endoscopic Common Bile Duct Exploration

Robotic-Assisted Transcystic Endoscopic Common Bile Duct Exploration
Marc Mankarious, MD1; Benjamin S. C. Fung, MD, FRCSC2; Joshua S. Winder, MD1
1Penn State Health Milton S. Hershey Medical Center
2North York General Hospital, University of Toronto

Choledocholithiasis complicates cholecystectomy in 10–15% of patients. In individuals with prior Roux-en-Y gastric bypass (RYGB), altered foregut anatomy renders traditional endoscopic retrograde cholangiopancreatography (ERCP) technically challenging or unsuccessful. This report details the use of robotic-assisted transcystic endoscopic common bile duct exploration (TCBDE) in a patient with RYGB and choledocholithiasis. For patients with surgically altered anatomy and urgent need for stone clearance, robotic TCBDE represents a safe, cost-effective, single-stage alternative to two-stage approaches, effectively bypassing the anatomical limitations imposed by RYGB.

General Surgery, Print Release

PUBLISHED: Robotic Cholecystectomy for Recurrent Gallstone Pancreatitis in a Patient with Prior Distal Pancreatectomy and Splenectomy for Acinar Cell Carcinoma

Robotic Cholecystectomy for Recurrent Gallstone Pancreatitis in a Patient with Prior Distal Pancreatectomy and Splenectomy for Acinar Cell Carcinoma
Charles C. Vining, MD, FACS, FSSO; Lawrence M. Knab, MD, FACS, FSSO; Rushin D. Brahmbhatt, MD, FACS
Penn State Health Milton S. Hershey Medical Center

Recurrent gallstone pancreatitis is a common and potentially morbid condition for which definitive cholecystectomy is recommended to prevent recurrent biliary complications and reduce hospital readmissions. Surgical management may be technically challenging in patients with prior pancreatic resection because of altered anatomy, adhesions, and concern for malignancy recurrence. This video demonstrates a robotic-assisted cholecystectomy performed in a 78-year-old man with recurrent gallstone pancreatitis and a history of distal pancreatectomy for pancreatic acinar cell carcinoma. Preoperative imaging demonstrated cholelithiasis without evidence of recurrent malignancy. Diagnostic laparoscopy was performed to exclude occult intra-abdominal disease before proceeding with cholecystectomy. Operative findings included chronic cholecystitis and cholelithiasis. Robotic dissection facilitated meticulous clearance of fibrofatty tissue within the hepatocystic triangle and safe dissection around the cystic structures prior to cystic duct division, consistent with established principles for preventing bile duct injury. The procedure was completed without complication. This case highlights the role of robotic-assisted cholecystectomy in patients with recurrent gallstone pancreatitis and prior pancreatic surgery, where enhanced visualization and instrument dexterity may improve operative safety in complex inflammatory and reoperative settings.

General Surgery, Global Surgery, Print Release

PUBLISHED: Open Cholecystectomy for Gallstone Disease

Open Cholecystectomy for Gallstone Disease
Liborio “Jun” Soledad, MD; Enrico Jayma, MD; Ted Carpio, MD
World Surgical Foundation

Gallstone disease is one of the most common disorders affecting the digestive tract. Most individuals with gallstones are asymptomatic and do not require treatment. For symptomatic patients, however, cholecystectomy is recommended.

Cholecystectomy is one of the most common abdominal surgeries performed worldwide. Indications include moderate-to-severe symptoms, stones obstructing the bile duct, gallbladder inflammation, large gallbladder polyps, and pancreatic inflammation due to gallstones.

Here, we report the case of a 53-year-old male with stones in his biliary duct. Despite having uncomplicated disease, the patient was treated with a primary open cholecystectomy because laparoscopy was not available.

General Surgery, Global Surgery, Preprint Release

PREPRINT RELEASE: Open Cholecystectomy


Open Cholecystectomy
Romblon Provincial Hospital

Liborio “June” Soledad, MD
World Surgical Foundation

Enrico Jayma, MD
World Surgical Foundation

Ted Carpio, MD
World Surgical Foundation

The patient in this case is a 53-year-old male with a 1-year history of recurrent right upper quadrant pain that radiates to the back. On workup, ultrasound revealed intraluminal gallstones. Here, Dr. Soledad, Dr. Jayma, and Dr. Carpio perform an open cholecystectomy on this patient while on a surgical mission to the Philippines with the World Surgical Foundation.