Bouveret syndrome


The patient proceeded to surgery for open duodenectomy:

  • midline laparotomy
  • large palpable gallstone in D2/3
  • kocherization of duodenum limited by cholecystoduodenal fistula superiorly
  • longitudinal duodenotomy over large gallstone on anterolateral aspect of D2/3
  • gallstone delivered, smaller gallstone more proximal also removed.
  • closed with omental patch

The patient recovered well, nil complications.