title: Salvage treatment of laparoscopic cholecystectomy-associated bile duct stenosis combining laparoscopic and endoscopic procedures: a case report.
abstract: The incidence of laparoscopic cholecystectomy (LC)-associated bile duct injury has reached a steady state despite learning curve effect. Herein we report the case of a 74-year-old Japanese man who suffered from bile duct stenosis and stones after LC. The stenosis was due to stricture caused by surgical clips used inappropriately during LC. We planned a salvage treatment combining laparoscopic and endoscopic approaches. At laparoscopic observation, the clips had already invaded the right side of the bile duct; minimal absorbable suture was performed after all the clips were removed. The bile duct stenosis was then endoscopically dilated and the biliary stones were successfully removed. For the recurrent biliary stenosis after discharge, endoscopic balloon dilation was performed and multiple plastic stent tubes were placed. The stent tubes were removed 4 months later, and the patient has had no symptoms for 1 year. A combined laparoscopic and endoscopic approach was useful for the salvage treatment of LC-associated bile duct stenosis.
authors.affiliation: Department of Surgery, Hyogo College of Medicine, Nishinomiya, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Iimuro
authors.forename: Toshihiro
authors.initials: T
authors.lastname: Okada
authors.forename: Koichiro
authors.initials: K
authors.lastname: Ohashi
authors.forename: Yugo
authors.initials: Y
authors.lastname: Uda
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Suzumura
authors.forename: Jiro
authors.initials: J
authors.lastname: Fujimoto
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D003251:Constriction, Pathologic / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005500:Follow-Up Studies; D042882:Gallstones / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D006801:Humans; D008297:Male; D016879:Salvage Therapy / Q000379:methods*; D015607:Stents
keywords: Biliary stenosis; laparoscopic cholecystectomy; salvage surgery