Fishbone migration to bile ducts after pancreaticoduodenectomy: a case series

  • Masaaki AkahaneEmail author
  • Masashi Kusakabe
  • Mizuho Murakami
  • Ichiro Shirouzu
  • Mariko Terasaki
  • Junichi Kazaoka
  • Hiroki Sasaki
  • Haruyasu Yamada
Special Section: Distinguished Papers from JSAR


We reviewed six cases suspected of having fish bones in the bile ducts on follow-up CT following pancreaticoduodenectomy. The period from surgery to CT examination in which fishbone migration was first suspected ranged from 282 to 1157 days with a median of 517 days. The fish bone in the bile duct disappeared in five out of six cases on subsequent CT. One case was complicated by hepatolithiasis, and the other five cases showed no biliary complications. In two cases, wandering of fish bones in the jejunal limb was observed on CT images before their migration into the bile ducts. Asymptomatic migration of fish bones to the bile ducts following pancreaticoduodenectomy is not rare, but serious complications can occasionally occur. Indications of intervention may be controversial in asymptomatic cases, but once fish bones are observed in the biliary tree or the jejunal limb, dietary instructions advising not to swallow fish bones may be a good option to prevent complications.


Foreign bodies Pancreaticoduodenectomy Bile ducts Gallstones Cholangitis 


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© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Radiology, Mita HospitalInternational University of Health and WelfareTokyoJapan
  2. 2.NTT Medical CenterTokyoJapan
  3. 3.Japanese Red Cross Saitama HospitalSaitamaJapan

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