2006 Volume 39 Issue 6 Pages 672-676
In September, 2003 a 41-year-old woman was admitted for epigastric pain, vomiting, and fever. She had undergonep revious surgery in June, 2000 for an anomalous pancreaticobiliary duct junction and congenital biliary dilatation. On admission in 2003 computed tomography showed intrahepatic biliary dilatation involving the lateralpart of the left lobe that was unassociated with tumor. Percutaneous transhepatic choledochoduodenography showed bile duct stricture at the site where a retrograde transhepatic biliary drainage (RTBD) tube has been inserted in 2000. The intraoperative pathologic diagnosis of a frozen section specimen was benign biliary stricture with inflammatory cell infiltration and fibrosis, and lateral segmentectomy was performed instead of left lobectomy. Punctures of intrahepatic bile ducts with an RTBD tube should be performed with a sufficiently fine tube as peripherally as possible to avoid postoperative complications, such as inflammatory biliary stricture. When a wider biliary drainage tube is needed, it should be inserted via the alimentary tract rather than via the liver.
