総胆管空腸吻合術後に発症した肝内胆管癌にNon-covered metallic stentが,逆行性胆管炎にCovered metallic stentが有効であった1例

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  • A case in which covered metallic stent was effective for the prevention of retrograde cholangitis with cholangiocarcinoma after choledochojejunostomy

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In May 2003, a 69-year-old woman complaining of right hypochondralgia and fever was admitted to our hospital for the detailed physical examination. On the blood test, total bilirubin=2.9 mg/dl, CRP=31.2mg/dl, WBC=10,100/μlwere recognized. Abdominal US showed a hyperechoic lesion in S5, r=83mm. Abdominal CT scan detected a low density area in porta hepatis, and demonstrated dilatation of the intrahepatic bile duct. PTC revealed that the middle part of the bile duct and jejunum had been anastomosed, and that the bile duct in the left lobe was defected.<BR>Irregular findings were seen around the junction of the bile duct in the left lobe. Cholangioscopic examination detected granular sessile lesions in ductus hepatic sinister; biopsy of the bile duct and cytology of bile found adenocarcinoma; and diagnosis of cholangiocarcinoma was made. To prevent retrograde infection from the anastomosed area, covered metallic stent was placed in common bile duct. Non-covered metallic stent was also placed in ductus hepatic dexter to keep it from being clogged up by the tumor growth. No recurrence of cholangitis occurred thereafter.

収録刊行物

  • Tando

    Tando 18 (2), 224-228, 2004

    Japan Biliary Association

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