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Postoperative bile duct stricture

Case contributed by Ammar Haouimi
Diagnosis almost certain

Presentation

Laparoscopic cholecystectomy for cholelithiasis two weeks ago, presented with obstructive jaundice and pruritis.

Patient Data

Age: 45 years
Gender: Female

Moderate dilatation of the intrahepatic biliary ducts with an abrupt smooth cutoff 1 cm distal to the biliary bifurcation most likely due to a ligation injury during surgery. A T2 hypointense artifact is seen at the missing segment of the common hepatic duct corresponding most likely to a surgical clip. The common bile duct appears of normal size.

Case Discussion

MRI appearances are suggestive of an iatrogenic postoperative bile duct stricture type II (less than 2 cm from the biliary bifurcation) according to Bismuth classification

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