Ischemic biliary stricture due to lymph node dissection in the hepatoduodenal ligament

We report on 2 cases of ischemic biliary stricture after radical lymphadenectomy in the hepatoduodenal ligament with skeletonization of the extrahepatic bile ducts for malignant diseases. In both cases, histologic examination of the subsequently resected biliary strictures revealed evidence of ischemia. Skeletonization of the bile ducts may result in ischemia and stricture formation. In patients who require thorough dissection of the hepatoduodenal lymph nodes, bile duct resection should be considered.