Neuromas of the extrahepatic bile ducts as a cause of obstructive jaundice

We present four cases of extrahepatic bile duct neuromas causing obstructive jaundice. Two patients with neuromas localized in the hepatic duct had no evidence of gallstones or history of previous surgery. In these subjects, partial resection of the common bile duct and cholecystectomy was followed by hepatico-jejunostomy with Roux-en-Y reconstruction. In another patient, 7 years after cholecystectomy, a neuroma localized in the hepatic duct was treated by insertion of a T-tube. In the fourth patient, 9 years after laparoscopic cholecystectomy, partial common bile duct resection and Roux-en-Y hepatico-jejunostomy was performed. In all cases, the correct diagnosis of this very rare cause of extrahepatic bile duct obstruction was established postoperatively.