A case of inflammatory pseudotumor caused by non-absorbable polymer clip (NAPC, Hem-o-Lok®) in laparoscopic cholecystectomy Yukari KIHARA 1 , Yutaka TAKEDA 1 , Yoshiteru KATSURA 1 , Yoshiaki OHMURA 1 , Takuya SAKAMOTO 1 , Kohei MURATA 1 1Department of Surgery, Kansai Rosai Hospital Keyword: Hem-o-Lok® , 炎症性偽腫瘍 , 腹腔鏡下手術 pp.385-390
Published Date 2020/9/15
DOI https://doi.org/10.11477/mf.4426200835
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 An 80-year-old man with a medical history of laparoscopic cholecystectomy underwent endoscopic sphincterotomy (EST) for choledocholithiasis which was diagnosed on abdominal CT image taken to evaluate an abdominal aortic aneurysm. Follow-up MRCP after EST indicated a mass in the upper bile duct which was suspected to be cholangiocarcinoma. Since malignancy could not be ruled out by preoperative IDUS, laparoscopic bile duct resection and reconstruction were performed. The resected mass located in the common bile duct was covered with granulation tissue, and we found a non-absorbable polymer clip (NAPC ; Hem-o-Lok®) inside. Pathological diagnosis was an inflammatory pseudotumor (IPT) caused by a migrated NAPC. NAPCs are being used more frequently with the widespread use of laparoscopic liver resection. It is difficult to discriminate IPT from malignant tumor on preoperative imaging. Here, we recommend recognizing the possibility of IPT as a differential diagnosis in patients who have undergone laparoscopic surgery.

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