Laparoscopic management of biliary obstruction secondary to sarcoidosis

Abstract

Evaluation of the patient presenting with an elevated bilirubin often involves a study of the biliary tract for potential obstruction. Potential etiologies for obstruction of the common bile duct (CBD) include choledocholithiasis, pancreatic or ampullary neoplasm, cholangiocarcinoma, or extrinsic compression. Extrinsic compression can be from the gallbladder itself (Mirizzi's syndrome) or a neoplasm in adjacent lymph nodes. We describe an unusual cause of CBD obstruction -sarcoidosis; as well as the workup, and the laparoscopic treatment of regional sarcoidosis.

Hepatic sarcoidosis resembling primary sclerosing cholangitis

“…As a sum, these cases demonstrate that the correct diagnosis can save the patient from invasive procedures, emotional stress in cases of misdiagnosed cholangiocarcinoma, 17 and even surgery, such as liver transplantation and exploratory laparotomies. 18 The leading mimicker PSC is a chronic, progressive disease that insidiously destroys the biliary ducts and eventually leads to cirrhosis and liver transplantation. It is more common in men than women and has a strong association with inflammatory bowel disease.…”

“…As a sum, these cases demonstrate that the correct diagnosis can save the patient from invasive procedures, emotional stress in cases of misdiagnosed cholangiocarcinoma, 17 and even surgery, such as liver transplantation and exploratory laparotomies. 18 …”