A Case of Bile Duct Stricture Associated with an Abnormal Extrahepatic Portal Vein

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 76; no. 8; pp. 2013 - 2020
• Main Authors: MASUDA, Takahito, TAKEUCHI, Dan, SHINODA, Kimio, FURUKAWA, Katsunori, YOICHI, Takuya, MIYAZAKI, Masaru
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2015
• Subjects: abnormal portal vein; biliary obstruction; surgical approach
• DOI: 10.3919/jjsa.76.2013
• ISSN: 1345-2843

The non-surgical management of benign biliary obstruction consists of endoscopic retrograde cholangiopancreatography and stent insertion whenever possible ; however, the stent must be changed at regular intervals, which involves patients undergoing repeated endoscopic procedures. A 72-year-old man was referred owing to cholangitis and progressive jaundice. Magnetic resonance cholangiopancreatography demonstrated a stricture in the common bile duct (CBD), while a computed tomography scan revealed an abnormal portal vein that was deemed to be the cause of the CBD compromise. The case was initially managed by endoscopic retrograde biliary drainage and stent insertion. The patient was informed that regular stent changes would be required over the long term ; however, he requested definitive surgical management of his condition and underwent choledochojejunostomy and cholecystectomy. He made an uneventful recovery and remains well 3 years postoperatively with no recurrence of the cholangitis. Here we reported a case of a patient presenting with biliary obstruction caused by an abnormal extrahepatic portal vein, an unusual cause. The use of definitive surgical management prevented the need for recurrent stent changes and improved the patient's quality of life.