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논문 기본 정보

자료유형
학술저널
저자정보
Young-In Yoon (University of Ulsan) Shin Hwang (University of Ulsan) Gi-Young Ko (University of Ulsan) Jae-Jun Lee (University of Ulsan) Chul-Min Kang (University of Ulsan) Ji-Hyun Seo (University of Ulsan) Yong-Jae Kwon (University of Ulsan) Sung-Jin Cheon (University of Ulsan)
저널정보
한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제19권 제2호
발행연도
2015.5
수록면
66 - 70 (5page)

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We present a rare case of functional stenosis of the jejunal loop following left hepatectomy and hepaticojejunostomy long after pylorus-preserving pancreaticoduodenectomy (PPPD), which was successfully managed by balloon dilation. A 70-year-old Korean man had undergone PPPD 6 years before due to 1.8 cm-sized distal bile duct cancer. Sudden onset of obstructive jaundice led to diagnosis of recurrent bile duct cancer mimicking perihilar cholangiocarcinoma of type IIIb. After left portal vein embolization, the patient underwent resection of the left liver and caudate lobe and remnant extrahepatic bile duct. The pre-existing jejunal loop and choledochojejunostomy site were used again for new hepaticojejunostomy. The patient recovered uneventfully, but clamping of the percutaneous transhepatic biliary drainage (PTBD) tube resulted in cholangitis. Biliary imaging studies revealed that biliary passage into the afferent jejunal limb was significantly impaired. We performed balloon dilation of the afferent jejunal loop by using a 20 mm-wide balloon. Follow-up hepatobiliary scintigraphy showed gradual improvement in biliary excretion and the PTBD tube was removed at 1 month after balloon dilation. This very unusual condition was regarded as disuse atrophy of the jejunal loop, which was successfully managed by balloon dilation and intraluminal keeping of a large-bore PTBD tube for 1 month.

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INTRODUCTION
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UCI(KEPA) : I410-ECN-0101-2016-514-001503491