Pseudostenosis of the Common Hepatic Duct caused by Compression of the Cystic Artery

Yusuke Arakawa, Mitsuo Shimada, Hideaki Uchiyama, Satoru Imura, Yuji Morine, Hirofumi Kanemura, Jun Hanaoka, Mami Kanamoto, Koji Sugimoto and Masaki Nishi

Department of Surgery, University of Tokushima Graduate School

Bile duct way stenosis mimic malignant such as cholangiocellular carcinoma lesions and gall bladder carcinoma invasion. A 74-year-old woman a gallbladder (GB) polyp combined with common hepatic duct (CHD) stenosis was found in admitted for surgery to treat. Preoperative evaluation revealed to have a polypoid tumor 12 mm in diameter and relatively smooth CHD stenosis. Because the possibility of malignancy could not be excluded, she underwent open abdominal surgery. We conducted the usual cholecystectomy. The CHD was compressed by the cystic artery, so we thoroughly confirmed the absence of any suspicious CHD lesion by directly inspecting the inner side of the stricture by choledochotomy. The definitive diagnosis of the GB tumor was early GB carcinoma. Although CHD compression by the cystic artery is considered uncommon, we suggest that it should be included in the differential diagnosis of extrahepatic biliary stenosis, especially when biliary stenosis is relatively smooth.

Key words
bile duct stenosis, cystic artery

Reprint requests
Yusuke Arakawa Department of Surgery, Institute of Health Biosciences, University of Tokushima
3-18-15 Kuramoto-cho, Tokushima, 770-8503 JAPAN

Accepted
September 16, 2009

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