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  • A Case of Limy Bile Associated with Cholecystolithiasis and Choledocholithiasis.

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A 61-year-old man was admitted to the hospital because of right hypochondralgia. Abdominal computed tomography and ultrasonography revealed calcification in the gallbladder and the common bile duct, and cholecystolithiasis and choledocholithiasis were diagnosed. And limy bile in the gallbladder was suspected because a round calcification at the right hypochondriac region was detected by a plain x-ray film in supine position, and niveu formation at standing position. After an ENBD tube was placed in the left hepatic duct, he underwent a laparoscopic cholecystectomy, followed by EPPD as well as removal of the stones of common bile duct with an interval of 4 days. In the case of limy bile, the cystic duct was usually obstructed. So, cholangiograhy from the cystic duct during the operation is sometimes difficult. And the stones in the cystic duct can accidentally fall into the common bile duct during the procedure. We suggest that the placement of an ENBD tube must be kept during perioperation period.

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