Gallstone&

bariatric surgeryCase presentation by:

(8 months ago:) Mini gastric bypass

+ Ursoflor 600mg/d for 6months

2

▫ F 42 yr., Ht: 165 cm, wt:125 kg, BMI: 45.9▫ PMH: DM ( since 2 yrs. ago) ▫ DH: NovoMix Insulin 40 U/d▫ Sonography: sludge in gallbladder▫ Endoscopy: Mild gastritis, H.pylori (+) → H.pylori eradication

Postop:Biliary colic (×2)Sonography : multiple gallstones, 2-3 mm in size

3

Surgical plan was temporarily suspended.(after the medical therapy is completed,surgery will be executed in case of pain)

➢ Symptoms : Severe Ruq pain, Fever, obstructive jaundice

➢ Sonography : multiple gallstones, 4-6mm in size, CBD: 12mm

➢ MRCP: multiple tiny stones in CBD

4

Lab data:

WBC: 15000, N:88%

T. Bile: 8.5, D. Bile :5

Alk.P: ×3 NL

GGT: 1150

5

Recommendation?

Thanks

7