Nonsurgical treatment of benign postoperative biliary stricture with the aid of percutaneous transhepatic choledochoscope (PTCS) was performed in an 80-year-old female. She had experienced recurrent episode of biliary colic and jaundice since seven months after cholecystectomy, and was refered to our hospital for thorough evaluation. Endoscopic retrograde cholangiopancreatography and percutaneous transhepatic cholangiography revealed band-like stricture at the junction of cystic and common hepatic duct. Postoperative biliary stricture was indicated and PTCS was performed. Endoscopic findings revealed no abnormality on the mucosal surface. Biopsy specimen concomitantly obtained from narrowed lumen revealed chronic inflammatory reaction as its etiology, and ruled out malignancy. A straight guide wire was passed through the markedly narrowed lumen easily under endoscopic guidance. A remnant silk probably left at the surgical procedure was found at the reopened nassowed lumen and was removed endoscopically. Stricture dilatation with baloon catheter was performed followed by retention catheter left in place for a month. She became free of symptoms and no sign of recurrence has been found till now, seven months after the procedure. PTCS was found to be of value at the treatment of these biliary strictures.
