複雑な胆管損傷の管理における生分解性胆道ステントの内視鏡使用

A man in his 50s sustained a Strasberg type D bile duct injury during laparoscopic cholecystectomy, which was initially misdiagnosed as a minor bile leak. Upon referral, he presented with abdominal pain, sepsis and a large biloma. Endoscopic retrograde cholangiopancreatography (ERCP) with plastic stent placement and percutaneous drainage resolved the leak, but a severe stricture of the common hepatic duct persisted. A biodegradable polydioxanone-based biliary stent was subsequently deployed, resulting in complete stricture resolution and improved ductal patency at 6-month follow-up, with no complications. This case illustrates the potential role of biodegradable stents in managing complex biliary injuries.