合流部結石（Confluence Stone）の1治験例

Confluence stone is a rare disease that is difficult to diagnose before surgery and thattend to accompany intraoperative biliary tract injury and postoperative stenosis, unexpectively.We have report a case of confluence stone.The patient was 67-year-old woman. During treatment for cholecystolithiasis at anotherhospital, she had upper abdominal pain three times without fever up and jaundice. Shewas reffered to our hospital for a detailed examination. Ultrasonography, CT and endoscopicretrograde cholangiopancreatography (ERCP) allowed a diagnosis of common bileduct stenosis caused by confluence stone. Laparotomy was then performed. No malignancywas shown despite of seveve cholecystitis. Thus cholecystectomy was carried out,then the biliary stenosis was repaired by patch graft method.It is known that confluence stone arise biliostasis with the progression of chroniccholecystitis. Therefore, in cases of severe chronic cholecystitis we should consider thepossibility of the confluence stone and take care of the biliary tract injury and postoperativestenosis.