Abstract
A 73-year-old man with lower bile duct cancer underwent pancreaticoduodenectomy. A stent tube 8 cm in length made of polyvinyl chloride for retrograde transhepatic biliary drainage (RTBD) known as the “lost tube” was placed at the anastomosis and fixed with an absorbable suture. A space-occupying lesion which was judged to be a calculus in the bile duct at the anastomotic site was detected by CT at 18 months after surgery. The patient was hospitalized 2.5 months later due to obstructive cholangitis. Endoscopic examination revealed that a stone adhered around the stent tube caused obstruction of the bile duct. Just after withdrawing the stent tube with the stone, many biliary stones flowed from the intrahepatic ducts. Theoretically, this type of stent would have dropped out naturally and have been discharged through the gastrointestinal tract. In the present case, the stent had lodged at the anastomotic site and formed a calculus around it. Although this seems to be a very rare complication of internal stent for bilioenteric anastomosis, it could be a possible cause for obstructive cholangitis as an example of a late complication.
