Abstract
RATIONALE: Obstructive jaundice caused by traumatic neuroma of the common bile duct is extremely rare and easily misdiagnosed. PATIENT CONCERNS: We herein report a 66-year-old female who presented with obstructive jaundice. Magnetic resonance cholangiopancreatography showed common hepatic duct stenosis accompanied by intrahepatic bile duct dilation. Nine months ago, a laparoscopic cholecystectomy was complicated by the transection of the common bile duct, which was treated with end-to-end anastomosis and T-tube drainage. After readmission, the patient underwent an exploratory laparotomy. DIAGNOSES: A soft tissue mass was intraoperatively identified to cause a common hepatic duct stricture. The frozen section of the mass showed a high possibility of neuroma. Postoperative immunohistochemistry staining confirmed a neuroma of the common bile duct. INTERVENTIONS: Neuroma resection and Roux-en-Y hepaticojejunostomy were performed. OUTCOMES: Postoperative recovery was uneventful. She was well after a postoperative 9-year follow-up. LESSONS: During cholecystectomy, the cystic duct and common hepatic duct should be carefully identified. In cases where severe inflammation or fibrosis in the Calot triangle makes dissection of the cystic duct difficult, a subtotal cholecystectomy can be done. Frozen section pathology examination during surgery can help avoid unnecessary, extensive radical surgery.