Department of Gastroenterology and Hepatology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan.
Nagoya J Med Sci. 2021 Aug;83(3):655-661. doi: 10.18999/nagjms.83.3.655.
A 45-year-old female was admitted to the hospital with a diagnosis of acute pancreatitis. A computed tomography scan showed two extrahepatic bile ducts. Magnetic resonance cholangiopancreatography suggested a stone in one of the bile ducts. Endoscopic retrograde cholangiopancreatography revealed two extrahepatic bile ducts joining at the hilum of the liver accompanied with pancreaticobiliary maljunction. Sphincterotomy was performed and a protein plug was drained from the bile duct. Several treatment options were discussed, and the patient was treated with laparoscopic cholecystectomy without extrahepatic bile duct resection and planned to be followed up considering the risk of carcinogenesis in the bile ducts.
一位 45 岁女性因急性胰腺炎被收入院。计算机断层扫描显示两条肝外胆管。磁共振胰胆管成像提示其中一条胆管内有结石。内镜逆行胰胆管造影显示两条肝外胆管在肝门处汇合,伴有胰胆管合流异常。行括约肌切开术,并从胆管中引流蛋白栓。讨论了几种治疗方案,患者接受了腹腔镜胆囊切除术,未行肝外胆管切除术,并计划进行随访,因为胆管存在癌变风险。