A CASE OF MEMBRANOUS STENOSIS AND REVIEW OF THE LITERATIVE

We experienced a case of membranous stenosis in the extrahepatic bile duct in a 53-year-old woman with gallstone who visited the hospital to undergo laparoscopic cholecystectomy. Twenty-one cases of this disease reported in Japan and this case were examined about the following: 1. The course from the motive of diagnosis to the definite diagnosis. 2. The location of septum and the presence or absence of stone. 3. The ethiology of the septum. 4. Treatment of the disease. Abdominal pain and jaundice were common as the chief complaints and ERC was the best method to reach the definite diagnosis. The ethiology of the disease has been explained either by a congenital theory or acquired theory. However, the congenital theory is predominant at present, because there are some cases of onset in children, there are some cases without stones, histologically the septum and bile duct wall have the same structure, and infiltration with inflammatory cells is found seldom. Since calcium bilirubinate considered to be formed by cholengitis induced by stenosis is observed by 84.6% at hepatic sites near to the septum, removal of the septum is required in the treatment.