Impacted Common Bile Duct Stone Managed by Hepaticoduodenostomy

A bypass procedure such as a hepaticoduodenostomy may be an alternative to the traditional choledochoduodenostomy in the management of the retained, impacted distal common bile duct (CBD) stone, especially in the presence of sepsis. We present herein a hepaticoduodenotomy performed for a retained, impacted distal CBD stone in a low-resource setting with a good outcome. This impacted stone had complicated an open cholecystectomy for acute cholecystitis by causing the dehiscence of the cystic duct stump as a result of distal biliary obstruction.