# Management of Choledocholithiasis After a Gastric Bypass Surgery: A Case Report

## TL;DR

This case report discusses managing gallstones in a patient who had gastric bypass surgery using a minimally invasive technique.

## Contribution

The report presents a successful case of choledocholithiasis management using percutaneous transhepatic stone advancement after gastric bypass.

## Key findings

- Percutaneous transhepatic stone advancement was successfully used to treat choledocholithiasis after gastric bypass.
- The case highlights the feasibility of a minimally invasive approach for this complex condition.
- Treatment options should follow a progression from least to most invasive.

## Abstract

Alteration of the anatomy following Roux-en-Y gastric bypass (RYGB) poses a significant challenge in choledocholithiasis management in patients who have undergone this operation. Many options exist, including endoscopic, surgical, percutaneous, or hybrid means with variable success rates. Treatment should progress from least to most invasive options. We present a case of choledocholithiasis two years following gastric bypass managed with percutaneous transhepatic stone advancement to the duodenum. The aim is to highlight different options for dealing with this pathology.