A Case of Acute Pancreatitis Due to Intraoperative Cholangiography in Laparoscopic Cholecystectomy

Matsumura Masaru, Tomita Daisuke, Fujisawa Kentoku, Murakami Hisashi, Kobayashi Masahiro, Okubo Satoshi, Shindoh Junichi, Imamura Tsunao, Takazawa Yutaka, Hashimoto Masaji

doi:10.5833/jjgs.2023.0047

<p>A 60-year-old man was referred to our hospital due to a protruded lesion of the gallbladder detected in a medical checkup. Endoscopic US showed diffuse small protruded lesions in the gallbladder. MRCP showed an anatomical anomaly in which the cystic duct formed a common trunk with the posterior segmental branch that ran into the common bile duct alone. No pancreatobiliary maljunction was observed. The possibility of a latent malignancy could not be ruled out, and laparoscopic cholecystectomy was performed. Intraoperative cholangiography was conducted from the cystic duct for early detection of possible misidentification of the bile duct. The cystic duct and posterior segment branch were visualized, and contrast medium also flowed into the pancreatic duct. The amylase concentration of the bile in the gallbladder was 43,875 U/l and the lipase concentration was 12,450 U/l. On the day after surgery, postoperative back pain appeared, and laboratory data showed increased serum amylase and C-reactive protein. Swelling of the pancreas and surrounding fat opacity were detected on CT, and acute pancreatitis was diagnosed. The patient recovered with conservative treatment. Pathological examination revealed hyperplastic change in the mucosa of the gallbladder without malignant findings. This case shows that visualization of the pancreatic duct by cholangiography during laparoscopic cholecystectomy may be a cause of development of pancreatitis.</p>

A Case of Acute Pancreatitis Due to Intraoperative Cholangiography in Laparoscopic Cholecystectomy

Bibliographic Information

Search this article

Description

Journal

References(15)*help

Keywords

Details 詳細情報について

Export

Report a problem