A case of pancreaticoduodenectomy after the placement of an expandable metallic stent

: This is a case report of a 75-year-old man who underwent pancreaticoduodenectomy and received a placement of an expandable metallic stent (EMS) for palliation of the biliary stricture following diagnosis as middle bile duct carcinoma. At a local hospital, abdominal computed tomography revealed multiple low-density lesions with peripheral enhancement in the liver. After being diagnosed as metastatic liver tumor with cholangiocarcinoma, an EMS was inserted for palliation of the biliary stricture on the basis of the diagnosis as unresectable carcinoma due to the metastatic lesion. One month after stenting, because of relieving the biliary obstruction, no hepatic tumors were detected in either lobe by computed tomography. Based on this finding, the lesions were diagnosed as inflammatory pseudotumor of the liver rather than as metastatic liver tumor. A pancreaticoduodenectomy was performed without removal of the EMS, and fortunately, we were able to divide the bile duct upstream of the EMS. However, insertion of a stent may increase the difficulty of operation in many cases.