title: Immunoglobulin G4-associated cholangitis mimicking cholangiocarcinoma treated by laparoscopic choledochectomy with intracorporeal Roux-en-Y hepaticojejunostomy.
abstract: Immunoglobulin G4 (IgG4)-associated disease is a recently recognized disease entity that is characterized by elevated serum IgG4 concentrations, abundant IgG4 lymphoplasmacytic infiltration, and dramatic steroid responses. IgG4-associated cholangitis is one manifestation of IgG4-associated disease. However, it is clinically challenging to make a preoperative differentiation between this rare disease and cholangiocarcinoma, especially for those with serum concentrations of IgG4 in the normal range. This article reports on a 57-year-old man with jaundice and upper abdominal discomfort. Imaging examination showed biliary stricture that closely resembled cholangiocarcinoma, and the patient's serum IgG4 concentration was normal. The patient underwent a laparoscopic choledochectomy with Roux-en-Y hepaticojejunostomy using an intracorporeal hand-sewn technique. He recovered quickly without any complications. We also present our experience in laparoscopic intracorporeal hand-sewn hepaticojejunostomy.
authors.forename: JiaQin
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of General Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310016, Zhejiang Province, China. mouyiping2002@163.com.
authors.forename: Yi-Ping
authors.initials: YP
authors.lastname: Mou
authors.forename: Yu
authors.initials: Y
authors.lastname: Pan
authors.forename: Ke
authors.initials: K
authors.lastname: Chen
authors.forename: Xiao-Wu
authors.initials: XW
authors.lastname: Xu
authors.forename: YuCheng
authors.initials: Y
authors.lastname: Zhou
mesh_terms: D000368:Aged; D000713:Anastomosis, Roux-en-Y; D001650:Bile Duct Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000276:immunology / Q000473:pathology / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D002761:Cholangitis / Q000175:diagnosis / Q000276:immunology / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D007074:Immunoglobulin G / Q000276:immunology*; D007582:Jejunostomy; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D011379:Prognosis
chemical_list: D007074:Immunoglobulin G