Three Cases of Benign Intrahepatic Bile Duct Strictures Suggesting Difficulties

Shiroh Miwa, Yasuhiko Hashikura, Hiroshi Kitamura, Toshihiko Ikegami, Tohru Kakazu, Hidetoshi Matsunami, Tohru Noguchi, Seiji Kawasaki, Masatoshi Makuuchi, Hiroyoshi Ota*

First Department of Surgery and *Department of Clinical Laboratory Medicine, Shinshu University School of Medicin

We present three cases of benign intrahepatic bile duct stricture which mimicked malignant stricture due to cholangiocellular carcinoma. Case 1 was a 61-year-old man with intrahepatic bile duct stricture in the right lobe coinciding with arterial involvement. Case 2 was a 58-year-old man with irregular biliary stenosis and a tumorous lesion on its proximal side in the lateral segment of the liver. Case 3 was a 45-year-old woman with complete obstruction of the bile duct in the lateral segment. In this case, tumorous lesions were demonstrated on intraoperative ultrasonography and proveed to be multiple abscess formation in the liver. For all the three cases we performed hepatic resection, and the histological examination revealed benign stricture. Since their operations, all patients are leading normal lives without any complaints or recurrence. The differential diagnosis is sometimes very difficult in such cases and the existence of bile duct stricture could cause cholangitis or cholangiocellular carcinoma, therefore, resection of the liver including abnormal biliary trees should be considered for the patients with undeniable malignancy and/or repeated cholangitis.

Key words
bile duct stricture, hepatic resection, cholangiocellular carcinoma

Reprint requests
Miwa Shiro First Department of Surgery, School of Medicine, Shinshu University
3-1-1 Asahi, Matsumoto-shi, 390 JAPAN

Accepted
May 11, 1994

To read the PDF file you will need Abobe Reader installed on your computer.