A Surgical Case of Recurrent Occlusion of Expandable Metallic Stent 6 Years after Biliary Endoprosthesis for Benign Stricture of Hepaticojejunostomy

Hiroshi Matuzaki, Shinichi Okazumi, Wataru Takayama, Akihiko Takeda, Toru Fukunaga, Masanori Ichinose^*, Kotaro Iwasaki, Takehide Asano and Takenori Ochiai

The Second Department of Surgery, Chiba Univercity Medical School, ^*Department of Surgery, Shioya General Hospital

We encountered a case of operation for recurrent occlusion of expandable mentallic stents (EMS) for postoperative benign stricture in a male 71-year-old patient who had previously undergone cholecystectomy and extrahepatic bile duct resection with bilateral hepaticojejunostomy for cholecystocholedocholithiasis in another in 1982. He was resently admitted to our service stenosis of the anastomosis and hepatolithiasis in 1990. After endoscopic lithotomy, EMS were placed in bilateral anastomoses. Although readmitted in December 1996 with cholangitis, he was promptly discharged with the EMS sufficiently intact. However, the patient developed fever and jaundice 3 weeks later, and severe setenosis of the left hepaticojejunostomy was confirmed on readmission. Attempts to relieve the stenosis by endoscopic treatment proved impractical, and peritoneotomy was performed. Because the EMS was firmly in cicatricial tissue partial surgical removal of the stent was required. The front of left hepaticojejunostomy was incised, and the incised jejunum was patched to the left hepatic duct. The outcome was excellent, and postoperative progress has been steady.

Key words
expandable metallic stents (EMS), benign biliary stricture, hepatico-jejunostomy

Reprint requests
Hiroshi Matsuzaki Department of Surgery, Funabashi Municipal Medical Center 1-21-1 Kanasugi, Funabashi, 273-8588 JAPAN

Accepted
May 23, 2001

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