Hepatic Ductoplasty for Iatrogenic Bismuth Type 2 Bile Duct Stricture: A Case Report

Overview

Journal Int J Surg Case Rep

Specialty General Surgery

Date 2018 Sep 2

PMID 30172055

Authors

Okamoto Hirotaka

Kazunori Takahashi

Wakana Hiroyuki

Kenji Kawashima

Daisuke Ichikawa

Fujii Hideki

Affiliations

Soon will be listed here.

Abstract

Introduction: Biliary enteric anastomosis is a well-known biliary reconstruction method. Anastomosis stricture is one of the complications of this procedure that occurs in some patients over the long-term. We report a successful case of hepatic ductoplasty combined with hepaticojejunostomy (H-J) for the treatment of iatrogenic Bismuth type 2 stricture.

Presentation Of Case: The patient was a 68-year-woman who had undergone choledochojejunostomy (C-J) 6 years earlier due to bile duct injury after laparoscopic cholecystectomy for cholelithiasis. She complained of recurrent chills and upper back pain. Cholangiography and computed tomography revealed a C-J anastomotic stricture with hepatolithiasis. The diagnosis was reflux cholangitis with hepatolithiasis due to C-J stricture and a fistula between the reconstructed jejunal limb and duodenum. Exploration was performed, and she underwent hepatic ductoplasty with H-J and hepaticolithotripsy. Surgery was performed uneventfully and the patient has remained well subsequently.

Discussion And Conclusion: We propose hepatic ductoplasty as a useful technique for the treatment of selected patients with a C-J stricture or narrow hepatic duct.

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