• Yuri Sakamoto, Yohei Takeda, Shiho Kawahara, Takuya Shimosaka, Wataru Hamamoto, Hiroki Koda, Taro Yamashita, Takumi Onoyama, Kazuya Matsumoto, and Hajime Isomoto.
• Division of Gastroenterology and Nephrology, Department of Multidisciplinary Internal Medicine, Tottori University, Faculty of Medicine, Japan.
• Intern. Med. 2022 Sep 1; 61 (17): 2613-2617.

AbstractA 65-year-old man had a history of cholecystectomy and treatment for cholelithiasis with a common bile duct incision. Owing to frequent cholangitis, he underwent choledochojejunostomy. Twenty years after the surgery, he was hospitalized for cholangitis and was suspected of having hilar cholangiocarcinoma based on imaging findings. Percutaneous transhepatic cholangioscopy using a SpyGlass™ DS (Boston Scientific, Marlborough, USA) showed gallstones and bile sludge in the bile ducts, but no tumors were noted. Electrohydraulic shockwave lithotripsy with double-balloon enteroscopy enabled complete stone removal; a direct visual biopsy with peroral cholangioscopy showed no malignancy in the bile duct.

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