Intrahepatic Biliary Stricture Caused by a Retrograde Transhepatic Biliary Drainage Tube: A Case Report

Hiroaki Ozasa, Ryoichi Shimizu, Hiroaki Toshimitsu and Katsuhiro Matoba

Department of Surgery, Ogori Daiichi General Hospital

In September, 2003 a 41-year-old woman was admitted for epigastric pain, vomiting, and fever. She had undergone previous surgery in June, 2000 for an anomalous pancreaticobiliary duct junction and congenital biliary dilatation. On admission in 2003 computed tomography showed intrahepatic biliary dilatation involving the lateral part of the left lobe that was unassociated with tumor. Percutaneous transhepatic choledochoduodenography showed bile duct stricture at the site where a retrograde transhepatic biliary drainage (RTBD) tube has been inserted in 2000. The intraoperative pathologic diagnosis of a frozen section specimen was benign biliary stricture with inflammatory cell infiltration and fibrosis, and lateral segmentectomy was performed instead of left lobectomy. Punctures of intrahepatic bile ducts with an RTBD tube should be performed with a sufficiently fine tube as peripherally as possible to avoid postoperative complications, such as inflammatory biliary stricture. When a wider biliary drainage tube is needed, it should be inserted via the alimentary tract rather than via the liver.

Key words
retrograde transhepatic biliary tube, benign biliary stricture, anomalous pancreaticobiliary duct junction

Reprint requests
Hiroaki Ozasa Department of Surgery, Ogori Daiichi General Hospital
862-3 Shimogou, Ogori, Yamaguchi, 754-0002 JAPAN

Accepted
December 16, 2005

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