title: A case of postoperative recurrent cholangitis after pancreaticoduodenectomy successfully treated by tract conversion surgery.
abstract: A 69-year-old man, who had undergone pylorus-preserving pancreaticoduodenectomy (PD) (Imanaga procedure) for duodenum papilla cancer 13 years prior, had a history of repeated hospitalization due to cholangitis since the third year after surgery and liver abscess at the 10th year after surgery. Gastrointestinal series indicated no stenosis after the cholangiojejunostomy. However, reflux of contrast media into the bile duct and persistence of food residues were observed. We considered the cholangitis to be caused by reflux and persistence of food residues into the bile duct. So, we performed the tract conversion surgery, Imanaga procedure to Child method. The postoperative course was good even after re-initiating dietary intake. He was discharged on the 19th day after surgery. He has not experienced recurrent cholangitis for 18 months. For patients with post-PD recurrent cholangitis caused by reflux of food residues like ours, surgical treatment should be considered because tract conversion may be an effective solution.
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan, massapuhanis@gmail.com.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shiihara
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Miura
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Kozo
authors.initials: K
authors.lastname: Konishi
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Sachiko
authors.initials: S
authors.lastname: Takeo
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Kakimoto
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Gen
authors.initials: G
authors.lastname: Hidaka
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Shibui
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Minamisono
authors.affiliation: Department of Surgery, Hofu Institute of Gastroenterology, Hofu-shi, Yamaguchi, Japan.
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Toda
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Uemura
authors.affiliation: Department of Surgery, Institute of Gastroenterology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
authors.forename: Masakazu
authors.initials: M
authors.lastname: Yamamoto