Obstructive Jaundice Secondary to Choledocholithiasis With Chronic Cholecystitis

Obstructive jaundice, usually from choledocholithiasis, often coexists with chronic cholecystitis and poses higher risks in the elderly. Timely diagnosis with ultrasonography (USG)/magnetic resonance cholangiopancreatography (MRCP) and prompt intervention are critical. This case report highlights the diagnostic approach, surgical management, and outcomes in elderly patients with large common bile duct (CBD) stones. A 78-year-old man presented with jaundice, abdominal pain, and fever. MRCP revealed a large common bile duct (CBD) stone measuring 3.0 cm with features of cholecystitis, confirming obstructive jaundice secondary to choledocholithiasis. Additional workup, including hepatitis A virus/hepatitis E virus (HAV/HEV) serology, ruled out viral causes. The patient underwent open cholecystectomy with CBD exploration with stone extraction and T-tube placement. Intraoperatively, a sludge-filled gallbladder and dilated cystic duct were noted. Postoperative recovery was uneventful with the complete resolution of obstructive symptoms. Successful stone extraction with surgical management remains effective for large CBD stones in elderly patients. Timely surgical intervention resolved biliary obstruction, emphasizing the efficacy of open CBD exploration for complex choledocholithiasis in geriatric patients.