Abstract
We report two cases of hepaticolithiasis associated with benign biliary strictures after pancreaticoduodenectomy (PD). Case1 : A 74-year-old woman who had developed cholangitis after undergoing PD for serous cystadenoma was diagnosed 9 years later as having hepaticolithiasis. Case2 : A 79-year-old man was diagnosed as having hepaticolithiasis 5 years after undergoing PD for carcinoma of the papilla of Vater. In both cases, we dilated the biliary strictures by increasing the size of the percutaneous transhepatic biliary drainage (PTBD) tube and performed percutaneous transhepatic cholangioscopic lithotomy (PTCSL). After biopsy confirmation of the absence of any evidence of malignancy at the biliary-enteric anastomosis, both patients were discharged with indwelling transhepatic stents (18-French). They remained asymptomatic at the 4- and 3- month follow-up, respectively. With the increasing frequency of long-term survivors after PD, the incidence of hepaticolithiasis after PD is also increasing. Therefore, long-term follow-up of patients undergoing PD is important.
