A CASE OF BENIGN BILIARY STRICTURE AFTER CHOLEDOCHOJEJUNOSTOMY THAT WAS SUCCESSFULLY MANAGED USING A FULLY COVERED SELF-EXPANDING METALLIC STENT

Abstract

A 70-year-old woman was hospitalized due to acute cholangitis one year after resection of the extrahepatic bile duct and choledochojejunostomy for malfusion of the pancreatobiliary ducts. She underwent percutaneous transhepatic biliary drainage (PTBD), and after her general condition improved, we tried to introduce a guidewire for internal drainage but were unable to do so because of severe anastomotic stenosis. Using a bronchoscope as a slim endoscope, we inserted the bronchoscope via the PTBD route and visualized a punctiform scar. Subsequently, we were able to pass the guidewire and a drainage tube through the stricture, followed by placement of a fully covered self-expanding metallic stent. The stricture became dilated and we removed the stent four months later. Thereafter, we injected contrast medium into the bile ducts via the PTBD route and confirmed dilatation of the stricture, allowing removal of the PTBD tube. This case illustrates that a fully covered self-expanding metallic stent can be used to dilate an area of biliary stricture continuously and can be removed later. This approach is effective and feasible for management of benign biliary strictures.