INFLAMMATORY PROTRUDING LESION IN THE INTRAHEPATIC BILIARY DUCT DIAGNOSED ON NARROW BAND IMAGING–VIDEOCHOLANGIOSCOPY

A 66‐year‐old woman who had a repeated history of cholangitis since undergoing choledocho‐jejunostomy for post‐cholecystectomy common bile duct stricture, was referred to Kyoto University Hospital for further examination of the stricture of left intrahepatic biliary duct (IHBD). Endoscopic retrograde cholangiography (ERC) showed obstruction of the left IHBD with slightly protruding lesion. Peroral cholangioscopy (POCS) with narrow band imaging (NBI) demonstrated that a protruding lesion with papillary surface had neither tumor vessels on the surface of the tumor nor microvessel in each papillary projection. Biopsy presented only inflammation. Pathological analysis of the resected left lobe also showed only inflammatory change. NBI‐videocholangioscopy appears to be useful for diagnosing biliary disease by evaluating the tumor vessels including microvessel in papillary projection.