原発性硬化性胆管炎に合併した早期胆管癌に対し胆管壁部分切除後胆嚢管で胆管修復術を施行した１例

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  • 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.

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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.

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