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Vol.34 No.8 2001 August [Table of Contents] [Full text ( PDF 119KB)]
CASE REPORT

Repair of the Bile Duct by Cystic Duct Flap after Partial Resection of the Common Bile Duct for Early Bile Duct Cancer with Primary Sclerosing Cholangitis -A Case Report-

Kentaro Yoshimoto1), Hiroshi Takamori1), Tatsuya Tsuji1), Keiichiro Kanemitsu1), Ken-ichi Iyama2), Junji Tsuruta2), Kenji Noda3), Toshifumi Yasukawa3) and Takehisa Hiraoka1)

First Department of Surgery1) and Department of Surgical Pathology2), Kumamoto University School of Medicine Department of Surgery, Ogata Machi Hospital3)

A 71-year-old man was admitted due to abnormal gallbladder findings on echography had a papillary tumor in the common hepatic duct associated with primary sclerosing cholangitis (PSC) and intramural gallbladder cysts. Cholecystectomy and partial resection of the lateral wall of the common hepatic duct were conducted, but the cystic duct was preserved for use as a flap to cover the bile duct wall defect. Intraoperative histological examination of the common hepatic duct tumor revealed carcinoma in adenoma without tumor invasion of the surgical margin. To repair the bile duct, a cystic duct flap was made and placed over the ductal defect. Choledochojejunostomy was not done. Prevention of biliary infection and stenosis after bile duct resection is vital, especially in biliary reconstruction for bile duct cancer accompanying intrahepatic biliary stenosis such as PSC. Partial resection of the bile duct wall combined with repair of the bile duct for early bile duct cancer with PSC may thus be a useful option in avoiding postoperative biliary complications.

Key words
repair of the bile duct, primary sclerosing cholangitis, bile duct cancer

Jpn J Gastroenterol Surg 34: 1316-1320, 2001

Reprint requests
Hiroshi Takamori First Department of Surgery, Kumamoto University School of Medicine 1-1-1 Honjo, Kumamoto, 860-8556 JAPAN

Accepted
March 28, 2001

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