Abstract
A 77-year-old male was admitted due to jaundice. He had had a cholecystectomy 14 years previously. On CT scan and ERC, a wedge-shaped stenosis of the upper bile duct was found. The stenotic bile duct wall had a regular surface. There were many small stones in the enlarged intra-hepatic bile ducts ; the biliary cytoscopic diagnosis was class II. The patient was diagnosed as having benign biliary stenosis and stones. Endoscopic treatment was not successful. Thus surgery, which included resection of the stenotic bile duct, stone removald, and hepatocholangioenterostomy was done. On pathology, a dianogsis of benign biliary stenosis due to chronic cholangitis was made. Intraoperatve biliary injury is the most common cause of postoperative biliary stenosis. It could not be definitively determined whether in this the patient's intraoperative biliary injury had indeed occurred during the cholecystectomy done 14 years prior.
