Departmental Bulletin Paper 狭窄部背側にリンパ節様の結節を認めた良性胆管狭窄の1例(症例報告)

前平, 博充  ,  塩見, 尚礼  ,  村上, 耕一郎  ,  北村, 直美  ,  飯田, 洋也  ,  赤堀, 浩也  ,  新田, 信人  ,  生田, 大二  ,  貝田, 佐知子  ,  三宅, 亨  ,  山口, 剛  ,  清水, 智治  ,  仲, 成幸  ,  石田, 光明  ,  谷, 眞至

30 ( 1 )  , pp.1 - 5 , 2016-12-14 , 滋賀医科大学雑誌編集委員会
A 74-year-old woman was hospitalized with a liver abscess that was discovered during follow-up for biliary dilation and pancreaticobiliary maljunction. Abdominal computed tomography revealed a middle biliary stricture with a dorsal nodular lesion resembling a lymph node; we planned resection of the extrahepatic bile duct. However, subtotal stomach-preserving pancreaticoduodenectomy was performed because the dilated intra-pancreatic biliary duct could not be peeled from the pancreas. The resected specimen revealed that the form of the dilated biliary duct was multi-diverticular, and there was no mucosal change at the biliary stricture. Furthermore, fibrotic change was noted at the dorsal part of the biliary stricture. Histopathological assessment of the nodular lesion revealed inflammatory granulation, but malignancy was not evident in the resected specimens. In this case, the multi-diverticular form, the biliary stricture, and the nodular lesion developed because of repeated cholangitis. It was difficult to determine whether the biliary stricture in this patient was benign or malignant preoperatively, because of the appearance of the nodular lesion and the complications of congenital biliary dilatation and pancreaticobiliary maljunction.

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