A 69-year-old man underwent laparoscopy-assisted resection for transverse colon cancer. He visited our department approxiately 1 month after operation suffering from nausea and epigastric discomfort. Endoscopy and X-ray examination showed a severe stenosis in the second portion of the duodenum, which we believe was caused by the previous colectomy as indicated by no evidence of other causative event or factor found in his history or through thorough examination. He was then successfully treated by endoscopic balloon dilatation using of a controlled radial expansion wire-guided balloon dilatation catheter. We report a case of postoperative duodenal stenosis as an early complication following laparoscopy-assisted resection of transverse colon cancer. This case would be the first report documented in Japan that we are aware of. Furthermore, this experience suggested that endoscopic balloon dilatation for postoperative duodenal stenosis is effective.

Reconstruction of the way of bile flow was attempted in 21 cases with the resection of the dilated bile duct, and the post-operative courses were observed over a long period. It was found that ascending cholangitis is seldom caused by the hepaticoduodenostomy. It is important, when hepaticoduodenostomy is performed, that the sound section of the wall of the bile duct without stenosis in the hepatic side should be selected. Reconstruction of the way of the bile flow to prevent ascending cholangitis by leading normal bile flow into the duodenum should be devised.

No abstract