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We had 25 patients with the stricture at the upper portion of the biliary ductal system in these 15 years. Of the 25, excluding 3 patients who presented the narrowing of the common hepatic duct due to "Mirizzi's phenomenom", 22 were associated with congenital cystic dilatation of the common bile duct. The strictures located approximately in the region of the hilus, such as at the junction of the intra- and the extrahepatic ductal system, hepatic ducts and the portion at which the right and the left hepatic ducts and/or the common hepatic duct united. Except for a patient with cystic dilatation of the common hepatic and the common bile duct, 21 patients had segmental dilatation of the main intrahepatic and the whole extrahepatic bile ducts. And of the 21, 16 had primary stones in the intrahepatic bile duct proximal to the stricture. The shape of the intrahepatic ductal system of the 16 with intrahepatic calculi were entirely resemble to that of the 5 patients without intrahepatic calculi. Histological aspects of the wall of the stricture presented no remarkable changes as compared with those of the surrounding dilated bile ducts. Accordingly, the strictures were considered to be formed congenitally.
財団法人日本消化器病学会の論文