Abstract
A woman in her thirties complaining of upper abdominal pain was admitted to our hospital with a diagnosis of gallbladder stone and choledochitis. Bile stone was not evident on cholangiography. Laparoscopic cholecystectomy was performed. On and after the next day, bile leakage appeared. Endoscopic retrograde cholangiography (ERC) revealed bile leak from the surgical stump of the cystic duct. Endoscopic nasobiliary drainage (ENBD) was thus started. On ERC performed again, a bile stone became apparent and endoscopic sphincterotomy (EST) was performed. Bile leakage was ameliorated and the patient was discharged from our hospital on the 10th postoperative day. It is etiologically considered that an increase in the bile duct pressure occurred by an incarcerated spilled bile stone might cause rupture at the surgical stump of the cystic duct, resulting in bile leakage. Bile leakage caused by a spilled stone rarely occurs. Clinical reports on the endoscopic intervention for postoperative bile leakage have been increasing. In this case, associated uses of ENBD, biliary stent, and EST would be necessary in accordance with conditions that vary from patient to patient.
