Abstract
An 77-year-old man who had undergone a pancreatoduodenectomy 17 years previously was admitted to our hospital because of fever and abdominal pain. An abdominal CT scan revealed dilatation of the intrahepatic bile duct. Percutaneous transhepatic cholangiography revealed a biliary stricture and a filling defect. Percutaneous transhepatic cholangioscopy demonstrated a brown fragile stone, which was pushed into the jejunum after disintegration. A silicone tube was then placed through the hepaticojejunostomy and left in place to dilate the stricture for 3 months. The patient has been doing well for 3 years after the treatment. Biliary stricture after pancreaticoduodenectomy occurs within 5 years in most cases, but there are some cases in which the stricture occurred after more than 10 years had elapsed. Percutaneous transhepatic cholangioscopy is considered useful for the diagnosis and treatment of this uncemmon condition after pancreaticoduodenectomy.
