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Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature

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World Journal of Hepatology 2019年第11期11卷 743-751页

作者： Ryo Ataka Takashi Ito Toshihiko Masui satoru seo Takamichi Ishii Satoshi Ogiso Shintaro Yagi Kojiro Taura Shinji Uemoto Department of Hepato-Biliary-Pancreatic Surgery and Transplantation Graduate School of Medicine Kyoto University

BACKGROUND Pancreaticobiliary maljunction(PBM)can be classified into two categories,PBM with congenital biliary dilatation(CBD)or PBM without biliary dilatation,and the management of PBM is often *** treatment for PBM with CBD is prophylactic flow diversion surgery,and some authors have reported that the incidence of cancer after extrahepatic bile duct excision is less than 1%.A very rare case of intrahepatic cholangiocarcinoma 6 years after flow diversion surgery for PBM with CBD is *** SUMMARY A 30-year-old man was diagnosed as having PBM with CBD,Todani classification type IVA,because of abnormal liver enzyme *** underwent flow diversion surgery and cholecystectomy,and the specimen showed adenocarcinoma foci,pT1,pStage *** and a half years passed without any recurrence of bile duct ***,6 years after his operation,computed tomography showed a gradually growing nodule in the bile *** positron emission tomography showed high uptake,and magnetic resonance imaging showed restricted diffusion *** double balloon enteroscopy,the nodule at the posterior bile duct-jejunum anastomosis was directly visualized,and its biopsy specimen showed *** patient underwent right lobectomy and biliary *** pathological diagnosis was intraductal papillary neoplasm with high-grade intraepithelial neoplasia,pTis,pN0,pStage *** patient’s postoperative course was uneventful,and he has had no recurrence up to the present *** This case suggests the necessity of careful observation after flow diversion surgery,especially when PBM with CBD is detected in adulthood.

关键词： Congenital biliary dilatation Pancreaticobiliary maljunction Cholangiocarcinoma Recurrence Metachronous neoplasm Case report

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