Proximal bile duct stricture caused by a pancreatic pseudocyst: intra-operative placement of a metallic stent.
A 61 year-old man presented with a proximal bile duct stricture caused by a pancreatic pseudocyst, which is of rare occurrence. Although it could not be determined pre-operatively whether the lesion was caused by cholangiocarcinoma or inflammatory disease, a laparotomy revealed that the proximal extrahepatic bile duct was surrounded and constricted by a pancreatic pseudocyst extending into the hepatoduodenal ligament. Since the stricture was not relieved only by removing the contents of the pseudocyst and surgical biliary diversion was considered too difficult, a self-expandable metallic stent was placed intra-operatively, at the strictured site, under ultrasonic guidance, via the transhepatic approach. The post-operative course of the patient was uneventful, and he remains well 22 months after the operation. The intra-operative placement of a metallic stent into the biliary tract can be an alternative option in the relief of biliary obstruction.
Maema
A
A
Second Department of Surgery, Faculty of Medicine, University of Tokyo, Japan.
Kubota
K
K
Bandai
Y
Y
Makuuchi
M
M
D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D001651:Cholestasis, Extrahepatic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003549:Cystic Duct; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy; D010192:Pancreatic Pseudocyst / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015607:Stents; D014057:Tomography, X-Ray Computed