BENIGN BILIARY STRICTURE CAUSED BY A GRANULOMA GROWING AROUND A LIGATURE OF THE CYSTIC DUCT 23 YEARS AFTER OPEN CHOLECYSTECTOMY.

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We present a rare case of foreign body reaction to a ligature causing benign biliary stricture. A 65-year-old man admitted to another hospital because of jaundice and appetite loss and pointed out a high level of serum total bilirubin in February 1997 was referred to the hospital for further examination. He had a past history of undergoing an open cholecystecomy for cholelithiasis in 1974. After admission to the hospital, an abdominal ultrasonography and an abdominal CT scan showed a dilatation of the intrahepatic bile ducts and a hilar mass, suggesting a possible diagnosis of bile duct cancer. The patient underwent a laparotomy, the findings of which revealed a hard mass 1.5 cm in diameter at the hepatic hilus. A resection of the hilar mass including the left lobe of the liver and common bile duct was performed, followed by a hepaticojejunostomy to the right hepatic duct. A pathologic examination of the specimen revealed a granuloma growing around a ligature of the cystic duct.
日本臨床外科学会の論文