A Case of Benign Bile Duct Stenosis caused by a Clip Two Years after Laparoscopic Cholecystectomy

Makoto Takahashi, Masahiko Satou, Takeshi Ohkubo, Suguru Watabe, Naoki Negami, Yasunori Ishido, Shuji Tamazaki and Tetsuya Saitou

Department of surgery, Saiseikai Kawaguchi General Hospital

We report a case of rather rare benign bile duct stenosis caused by a clip that developed two years after laparoscopic cholecystectomy (LC). A 68 year-old man who undergoing LC for cholelithiasis in May 2005 visited the hospital in May 2007 due to brown urine and weight loss and was hospitalized with symptoms of jaundice and liver dysfunction. Stenosis of the middle bile duct was found in abdominal computed tomography (CT) and magnetic resonance cholangiopancreatography. Direct cholangiography showed stenosis of the bile duct adjacent to a clip that had been used during LC. No increase in tumor markers was observed and the cytological bile diagnosis was class I. Surgery for suspected cholangiocarcinoma was conducted to resect the portion of the bile duct including the stenotic region in June 2007. Pathological examination indicated inflammatory changes, and a clip that had been used during LC was found in tissue outside the wall that pressed the bile duct. Since complications caused by metal clip use are increasing, new ways should be devised that do not require clip use, e.g., using an absorbent substance.

Key words
benign bile duct stenosis, laparoscopic cholecystectomy

Reprint requests
Makoto Takahashi Department of surgery, Saiseikai Kawaguchi General Hospital
5-11-5 Nishikawaguchi, Kawaguchi, 332-8558 JAPAN

Accepted
March 26, 2008

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