What is the treatment of choice for recurrent CBD stones with multiple strictures in commonn bile duct
This is a case of recurrent pyogenic cholangitis. Cutaneous hepaticojejunostomy is preferred treatment modality Treatment of recurrent pyogenic cholangitis Treated with a multidisciplinary approach (endoscopy, interventional Radiology and surgery) The long term goal of therapy is to extract stones, remove debris, and relieve strictures Roux-en-Y hepaticojejunostomy with subcutaneous afferent limb(Hudson loop) is safe and effective way to provide access to the biliary tree for stone extraction Ref : Sabiston 20th edition Pgno :1507
Hepaticojejunostomy
Cutaneous hepaticojejunostomy
Cholecystectomy
ERCP and sphincterectomy
G.I.T