Bile duct carcinoma arising from the anastomotic site of hepaticojejunostomy after the excision of congenital biliary dilatation: A case report

Yamamoto, Joji; Shimamura, Yoshiyuki; Ohtani, Izumi; Ohtani, Hiromi; Yano, Mitsuyasu; Fukuda, Katsutoshi; Nagata, Toshinori; Ishii, Masanori; Ohmura, Mitsuhiro; Todani, Takuji

doi:10.1016/s0039-6060(96)80151-6

Cited by 29 publications

(16 citation statements)

References 7 publications

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“…This so-called 'stump' cancer has been reported but caveats are usually added. Thus, Yamamoto et al 46 reported a 60-year-old women with anastomotic adenocarcinoma following earlier hepaticojejunostomy and excision of a choledochal dilatation. However, this had only been 5 years earlier.…”

Section: Risk Of Malignancy In Choledochal Malformationmentioning

confidence: 99%

Congenital Choledochal Malformation: Not Just a Problem for Children

Dabbas

Davenport

2009

annals

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Choledochal cysts remain relatively uncommon in Western Europe and the US, although they are appreciably more common in Asia. Their aetiology remains obscure although abnormalities of the pancreaticobiliary junction may be the primary pathology in some, with biliary dilatation following reflux of activated pancreatic secretions. Most anomalies will present in childhood with obstructive jaundice or abdominal pain; a proportion may only present for the first time during adulthood, and some of these will show malignant transformation. The classical triad of pain, jaundice and a palpable mass is, however, not common. Complete cyst excision, where possible, and biliary reconstruction remain the aims for most types although there is still some controversy about the type of reconstruction. Laparoscopic reconstruction is possible but is still very much an advanced technique. The risk of long-term problems post-surgery is significant. Whether this is due to recurrent pancreatitis secondary to the retained common channel and/or a distal stump, or due to the development of biliary tract malignancy is still a cause for concern and indicates the need for adequate, prolonged follow-up.

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Section: Risk Of Malignancy In Choledochal Malformationmentioning

confidence: 99%

Congenital Choledochal Malformation: Not Just a Problem for Children

Dabbas

Davenport

2009

annals

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“…[1][2][3][4][5][6][7][8][9] The extrahepatic bile duct and gallbladder are considered a common site of cancer in patients with an anomalous pancreatobiliary ductal junction. 10,11 The regurgitation of pancreatic juice into the bile duct and the accumulation of bile juice in an anomalous pancreatobiliary ductal junction lead to chronic changes and may stimulate genetic alterations. 2,3,5,[10][11][12][13][14] Biliary tract carcinoma rarely arises after surgery, but the pathologic bile duct left behind holds a potential risk of carcinoma development.…”

Section: Introductionmentioning

confidence: 99%

“…10,11 The regurgitation of pancreatic juice into the bile duct and the accumulation of bile juice in an anomalous pancreatobiliary ductal junction lead to chronic changes and may stimulate genetic alterations. 2,3,5,[10][11][12][13][14] Biliary tract carcinoma rarely arises after surgery, but the pathologic bile duct left behind holds a potential risk of carcinoma development. 3,5,12,15 Complete excision of the bile duct with the potential risk of malignant change is a well-accepted strategy for this condition.…”

Section: Introductionmentioning

confidence: 99%

“…3,5,12,15 Complete excision of the bile duct with the potential risk of malignant change is a well-accepted strategy for this condition. 2,4,5,9,[11][12][13]15 However, the excision of dilated intrahepatic biliary tributaries in patients with a type IV-A anomaly remains debatable. 2,[16][17][18][19][20] Chijiiwa et al reported that additional hepatectomy was unnecessary because intrahepatic cholangiocarcinoma (IHCC) was not found in any of 13 patients who underwent extrahepatic bile duct resection for type IV-A anomaly during follow-up from 2 months to 16 years.…”

Section: Introductionmentioning

confidence: 99%

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Intrahepatic cholangiocarcinoma arising 34 years after excision of a type IV-A congenital choledochal cyst: Report of a case

et al. 2009

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We report a rare case of intrahepatic cholangiocarcinoma (IHCC) arising many years after excision of a type IV-A congenital choledochal cyst. A 44-year-old man was transferred to our hospital with acute cholangitis more than 34 years after several operations for congenital biliary dilatation. Imaging showed a huge tumor in the left medial section of the liver, extending to the porta hepatis. Although he had no jaundice, the intrahepatic bile ducts showed cylinder-like dilatation with narrowing of the hilar bile duct. At surgery, the tumor was found to arise from the dilated intrahepatic bile duct just above the narrow portion. He underwent a left hepatic trisectionectomy with a vascular procedure. Microscopically, the tumor was confirmed to be moderate-to-well-differentiated tubular adenocarcinoma. Thus, when the narrow segment is left untouched, careful long-term follow-up is important to detect new lesions at an early stage.

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“…[1][2][3][4] The regurgitation of pancreatic juice into the bile duct and the accumulation of bile juice in an anomalous pancreatobiliary ductal junction leads to chronic changes and may stimulate genetic alterations in patients with an anomalous pancreatobiliary ductal junction. 1,[5][6][7][8] Biliary tract carcinoma rarely arises after biliary diversion surgery, such as roux-en-Y hepaticojejunostomy, but the remaining bile duct may predispose to carcinoma development for several years afterward. 1,5 Cases of cancer development in the biliary system more than 10 years after diversion surgery have been reported.…”

mentioning

confidence: 99%

Intrahepatic Cholangiocarcinoma Arising 33 Years After Excision of a Choledochal Cyst: Report of a Case

Nishiyama

Shinoda

Tanabe

et al. 2011

International Surgery

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We report a case of intrahepatic cholangiocarcinoma arising 33 years after excision of a choledochal cyst. A 61-year-old woman was admitted to our hospital complaining of fever. Thirty-three years ago she had undergone extrahepatic choledochal cystectomy and choledochojejunostomy for a choledochal cyst. Computed tomography showed a tumor in the anterior segment of the liver, extending to the posterior and medial segments and the right portal vein. Intrahepatic biliary stones were seen in the bile ducts. We performed extended right lobectomy. Microscopically, the tumor was cholangiocarcinoma. Most of the tumor area was composed of invasive adenocarcinoma but a carcinoma-in-situ component was also observed in some regions including the hilar bile duct, where an intrahepatic biliary stone was seen. This suggests that the cancer development could be related to intrahepatic cholestasis. Patients with choledochal cyst may have to be carefully followed up for more than 30 years even after diversion surgery.

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Bile duct carcinoma arising from the anastomotic site of hepaticojejunostomy after the excision of congenital biliary dilatation: A case report

Cited by 29 publications

References 7 publications

Congenital Choledochal Malformation: Not Just a Problem for Children

Congenital Choledochal Malformation: Not Just a Problem for Children

Intrahepatic cholangiocarcinoma arising 34 years after excision of a type IV-A congenital choledochal cyst: Report of a case

Intrahepatic Cholangiocarcinoma Arising 33 Years After Excision of a Choledochal Cyst: Report of a Case

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