A Case of Amputation Neuroma Appeared 15 Years after Laparoscopic Cholecystectomy Accompanied by Intrabiliary Migration of Surgical Clip

Kazuhiro Suzumura, Yuji Iimuro, Nobukazu Kuroda, Toshihiro Okada, Yasukane Asano, Junichi Yamanaka, Tadamichi Hirano, Koushi Oh, Takashi Nishigami* and Jiro Fujimoto

Department of Surgery and Department of Pathology*, Hyogo College of Medicine

We report a case of amputation neuroma accompanied by a surgical clip migrating into the common bile duct following laparoscopic cholecystectomy (LC) 15 years earlier. A 51-year-old man who had undergone LC for cholecystolithiasis 15 years earlier and admitted for suspected bile duct cancer was found in ERCP to have smooth stenosis of the common bile duct adjacent to surgical clips used during LC. We suspected benign bile duct stenosis, but the possibility of bile duct cancer could not be ruled out, so we conducted extrahepatic bile duct resection and hepaticojejunostomy, because no malignant evidence was obtained in frozen sections. We found the amputation neuroma at the bile duct stricture in histological inspection and that a surgical clip had migrated into the bile duct lumen. Biliary amputation neuroma is often caused by surgical injury to nerve fibers around the bile duct.

Key words
amputation neuroma, laparoscopic cholecystectomy, clip

Reprint requests
Kazuhiro Suzumura Department of Surgery, Hyogo College of Medicine
1-1 Mukogawa-cho, Nishinomiya, 663-8501 JAPAN

Accepted
September 24, 2008

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