{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:10:19Z","timestamp":1756365019852,"version":"3.44.0"},"reference-count":7,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2025,6,18]]},"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:p>De novo choledocholithiasis and hepaticojejunostomy stricture in patients with previous Roux-En-Y hepaticojejunostomy (REY HJ) pose a therapeutic challenge as conventional methods like endoscopic retrograde cholangiopancreatography are rendered ineffective due to anatomical alterations.<\/jats:p>\n               <jats:p>We present a case of a patient with de novo choledocholithiasis 2 decades after a previous common bile duct excision, REY HJ for type 1 choledochal cysts, performed when she was 2 weeks old. She presented with dyspepsia and cholestatic liver function tests and was noted to have HJ stricturing with intrahepatic choledocholithiasis. The use of intraoperative laser lithotripsy (LL) facilitated fragmentation and clearance of bile duct stones, allowing for surgery to be completed successfully laparoscopically. She had no significant postoperative complications, and follow-up evaluations confirmed sustained stone clearance.<\/jats:p>\n               <jats:p>This article reports the outcomes of LL as a complementary technique. Laparoscopic exploration, lithotripsy and stone extraction are viable options in selected cases.<\/jats:p>","DOI":"10.1136\/bcr-2024-262355","type":"journal-article","created":{"date-parts":[[2025,6,30]],"date-time":"2025-06-30T10:25:19Z","timestamp":1751279119000},"page":"e262355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Laparoscopic hepaticojejunostomy (HJ) enterotomy, stone extraction and laser lithotripsy post-childhood Roux-En-Y HJ for type 1 choledochal cyst"],"prefix":"10.1136","volume":"18","author":[{"given":"Yuan Wei","family":"Lim","sequence":"first","affiliation":[{"name":"Hepatopancreatobilary service, Department of Surgery, Changi General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5759-1700","authenticated-orcid":false,"given":"Hiang Jin","family":"Tan","sequence":"additional","affiliation":[{"name":"Hepatopancreatobilary service, Department of Surgery, Changi General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ming Yuan","family":"Tan","sequence":"additional","affiliation":[{"name":"Department of Surgery, Khoo Teck Puat Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adrian Kah Heng","family":"Chiow","sequence":"additional","affiliation":[{"name":"Hepatopancreatobiliary service, Department of Surgery, Changi General Hospital, Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,6,30]]},"reference":[{"key":"2025082723464476000_18.6.e262355.1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1007\/s00423-014-1246-y","article-title":"Surgical revision of hepaticojejunostomy strictures after pancreatectomy","volume":"400","author":"Prawdzik","year":"2015","journal-title":"Langenbecks Arch Surg"},{"key":"2025082723464476000_18.6.e262355.2","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1016\/j.pan.2020.04.017","article-title":"Cholangitis following biliary-enteric anastomosis: A systematic review and meta-analysis","volume":"20","author":"Birgin","year":"2020","journal-title":"Pancreatology"},{"key":"2025082723464476000_18.6.e262355.3","doi-asserted-by":"crossref","DOI":"10.1186\/s40792-023-01654-3","article-title":"Duodenojejunostomy for endoscopic management of biliary enteric anastomotic stricture inaccessible via balloon-assisted endoscopy: a case report","volume":"9","author":"Sakamoto","year":"2023","journal-title":"Surg Case Rep"},{"key":"2025082723464476000_18.6.e262355.4","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000216285.07069.fc"},{"key":"2025082723464476000_18.6.e262355.5","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1007\/s00464-009-0837-0","article-title":"Laparoscopic common bile duct exploration and holmium laser lithotripsy: a novel approach to the management of common bile duct stones","volume":"24","author":"Varban","year":"2010","journal-title":"Surg Endosc"},{"key":"2025082723464476000_18.6.e262355.6","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1016\/j.amjsurg.2017.05.020","article-title":"A novel laparoscopic transcystic approach using an ultrathin choledochoscope and holmium laser lithotripsy in the management of cholecystocholedocholithiasis: An appraisal of their safety and efficacy","volume":"215","author":"Xia","year":"2018","journal-title":"Am J Surg"},{"key":"2025082723464476000_18.6.e262355.7","doi-asserted-by":"crossref","DOI":"10.1097\/MD.0000000000014286","article-title":"Efficacy and safety of laparoscopic holmium laser lithotripsy in the treatment of complicated biliary calculus","volume":"98","author":"Jin","year":"2019","journal-title":"Medicine (Baltimore)"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2024-262355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T06:46:54Z","timestamp":1756363614000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2024-262355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6]]},"references-count":7,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,30]]},"published-print":{"date-parts":[[2025,6]]}},"alternative-id":["10.1136\/bcr-2024-262355"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2024-262355","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2025,6]]}}}