胆管胆管吻合後に発生した胆管断端神経腫の１例

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  • AMPUTATION NEUROMA AFTER BILIO-BILIARY ANASTOMOSIS

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We report a case of amputation neuroma occurred after bilio-biliary anastomosis. A 53-year-old male underwent a laparoscopic cholecystectomy for gallstone, then intraopetrative bile duct injury occurred and bilio-biliary anastomosis was carried out in 1996. Post-operative course was uneventful, however he started to have abdominal pain and marked jaundice and visited our hospital eight year after the operation. Ultrasonography, magnetic resonance images and computed tomography showed intrahepatic bile duct dilatation with severe stenosis of extrahepatic bile duct with common bile duct stones. PTCS showed scar like severe stenosis of the bile duct and the biopsy specimens taken from the stenotic lesion revealed no neoplastic changes. So the diagnosis of a benign bile duct stenosis was made and extrahepatic bile duct resection, removal of the bile duct stones and hepatico-jejunostomy was performed. Histopathologic examination disclosed fibrous tissue with prominent proliferation of nerve fibers, so called amputation neuroma. Careful follow up with periodical diagnostic image studies is important after the bilio-biliary anastomosis.

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