A case of amputation neuroma of the biliary tract after hepaticoduodenostomy

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  • 総肝管十二指腸吻合術後の遺残胆管断端神経腫の1例

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Abstract

An 81-year-old male received cholecystectomy, choledocholithotomy, and hepaticoduodenostomy for cholecystolithiasis, choledocholithiasis, and a perivaterian diverticulum of the duodenum in May 2003. During surgery, an intraductal papillary mucinous neoplasm (IPMN) of 18mm in diameter was found in the uncinate process of the pancreas, for which the patient was followed up postoperatively. As the patient then had multiple episodes of upper abdominal pain, a detailed examination was performed. The findings showed enlargement of IPMN, which was considered to be attributable to abdominal pain. In February 2005, PPPD was performed. Examination of a biopsy sample revealed a small nodule of 15mm in diameter in the pancreatic site of the bile duct stump. Histopathological evaluation of the nodule showed that it was a amputation neuroma of the biliary tract, while the IPMN of the pancreas was proved to be an adenoma. The postoperative course was uneventful without recurrence of abdominal pain. The histopathological findings suggested that the amputation neuroma of the biliary tract, as well as the IPMN of the pancreas, might have caused the postoperative upper abdominal pain.

Journal

  • Tando

    Tando 20 (5), 629-634, 2006

    Japan Biliary Association

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