Bile duct carcinoma arising from the anastomotic site of
hepaticojejunostomy after the excision of congenital biliary dilatation:
A case report
Joji Yamamoto, Yoshiyuki Shimamura, Izumi Ohtani, Hiromi Ohtani, Masatsugu
Yano, Katsutoshi Fnkuda, Toshinori Nagata, Masanori Ishii, Mitsuhiro Ohmura,
Takuji Todani
Surgery 119: 476-479, 1996
from: Departments of Surgery and Pathology, Chibanishi West Hospital, Chiba,
and Department of Pediatric Surgery, Kagawa Medical School. Kagawa. Japan
A significant association between congenital biliary dilatation
(CBD) and hepatobiliary malignancies is well established. The cause of the
association is presumed to be the reflux of pancreatic juice into the bile
duct and the accumulation of bile juice in choledochal cyst caused by anomalous
union of the pancreaticobiliary ductal system. These malignancies arise
mostly in the gallbladder and the extrahepatic bile duct. Therefore the
standard surgical management of CBD is to excise the whole extrahepatic
bile duct and to perform hepaticoenterostomy. We will describe a case of
a 60-year-old woman who had undergone cyst excision, cholecystectomy, and
Roux-en-Y anastomosis for CBD (Todani's classification type I) 5 years earlier
and who suffered from bile duct carcinoma arising in the anastomotic site
of hepaticojejunostomy. This is the second reported case of a carcinoma
that arose from the anastomotic site of hepaticojejunostomy for CBD.
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