[A case of amputation neuroma of the bile duct following video-laparoscopic cholecystectomy].
We report a case of neuroma of the common hepatic duct arising five years after cholecystectomy (laparoscopic then converted in laparotomy). A 73-years-old patient was admitted for obstructive jaundice. Ultrasonography, TC and cholangiography showed a nodular lesion of the common hepatic of 1 cm in diameter, causing a regular and important stenosis of the main bile duct. Histologic examination demonstrated neuroma. By the analysis of this and 42 other previously published cases, the following features of bile duct neuroma were outlined: 1) variable interval between cholecystectomy and the onset of jaundice (2 months to 40 years); 2) the same incidence after laparoscopic or laparotomic cholecystectomy; 3) the generally complicated postoperative course after first surgical approach; 4) the various localizations on the biliary tree (cystic, main bile duct, intrahepatic ducts); 5) the circumstances of onset are almost the same (obstructive jaundice); 6) the histologic examination is mandatory for a correct diagnosis; and 7) the best treatment is resection of the bile duct tract involved in neuroma and reconstruction of biliary tree with hepaticojejunostomy.
Cimaschi
D
D
Azienda Ospedaliera Ospedali Civili di Brescia, Presidio di Gardone Val Trompia, Unità Operativa di Chirurgia Generale, Università degli Studi di Brescia, Italy.
De Cesare
V
V
Pulcini
G
G
Cervi
E
E
Belloni
M
M
Liserre
B
B
Cervi
G C
GC
D000368:Aged; D000713:Anastomosis, Roux-en-Y; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D003138:Common Bile Duct Neoplasms / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D006801:Humans; D041781:Jaundice, Obstructive / Q000209:etiology; D008297:Male; D009463:Neuroma / Q000150:complications / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery; D016896:Treatment Outcome; D020535:Video-Assisted Surgery