Two Cases of Cholesterosis of the Common Bile Duct

Hiromi Tokumura, Fumito Shimizu, Fumiaki Tezuka*

Department of Surgery, Ogawara Town Hospital
^*Department of Pathology, The Research Institute for Chest Disease and Cancer, Tohoku University

Cholesterosis of the common bile duct was observed in two patients under peroperative cholangioscopy. Case 1: a 53-year-old man was admitted to our hospital because of fever and jaundice. Endoscopic cholangiography showed a round filling defect in the gallbladder and a small and irregular one in the lower portion of the common bile duct of 10 mm in diameter. Peroperative cholangioscopy revealed yellowish-white multipolypoid cholesterosis in the common duct just above the papilla of Vater. The resected gallbladder had one pure cholesterol stone and cholesterosis in the mucosal membrane of the fundus. Case 2: A 73-year-old woman, diagnosed as having cholecystolithiasis, had been taking ursodeoxycholic acid (300 mg/day) for 4 months. She underwent cholecystectomy and choledochotomy with T-tube drainage. There were no stones in the gallbladder, but the organ showed diffuse cholesterosis. We considered that cholesterol gallstones which had been present in the gallbladder had been dissolved and disappeared during 4 months'administration of ursodeoxycholic acid. About 10 spots of polypoid cholesterosis were observed, by peroperative cholangioscopy, in the suprapapillary portion of the common duct which was dilated to 17 mm in diameter. Histological examination showed that there were many foam cells in the subepithelial layers of the common duct.

Key words
cholesterosis, common bile duct, papilla of Vater

Reprint requests
Hiromi Tokumura Department of Surgery, Tohoku Rosai Hospital
4-3-21 Dainohara, Aoba-ku, Sendai, 981 JAPAN

Accepted
February 13, 1991

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