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Title: Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
Authors: Ataka, Ryo
Ito, Takashi  kyouindb  KAKEN_id
Masui, Toshihiko  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-4001-4824 (unconfirmed)
Seo, Satoru  kyouindb  KAKEN_id
Ishii, Takamichi  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0002-7461-9653 (unconfirmed)
Ogiso, Satoshi  kyouindb  KAKEN_id
Yagi, Shintaro  kyouindb  KAKEN_id  orcid https://orcid.org/0000-0001-7465-5761 (unconfirmed)
Taura, Kojiro  kyouindb  KAKEN_id
Uemoto, Shinji
Author's alias: 伊藤, 孝司
増井, 俊彦
瀬尾, 智
石井, 隆道
小木曾, 聡
八木, 真太郎
田浦, 康二朗
上本, 伸二
Keywords: Congenital biliary dilatation
Pancreaticobiliary maljunction
Cholangiocarcinoma
Recurrence
Metachronous neoplasm
Case report
Issue Date: 27-Nov-2019
Publisher: Baishideng Publishing Group Inc.
Journal title: World journal of hepatology
Volume: 11
Issue: 11
Start page: 743
End page: 751
Abstract: 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 controversial. The 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 reported. CASE SUMMARY: A 30-year-old man was diagnosed as having PBM with CBD, Todani classification type IVA, because of abnormal liver enzyme profiles. He underwent flow diversion surgery and cholecystectomy, and the specimen showed adenocarcinoma foci, pT1, pStage IA. Five and a half years passed without any recurrence of bile duct cancer. However, 6 years after his operation, computed tomography showed a gradually growing nodule in the bile duct. Fluorodeoxyglucose positron emission tomography showed high uptake, and magnetic resonance imaging showed restricted diffusion signals. On double balloon enteroscopy, the nodule at the posterior bile duct-jejunum anastomosis was directly visualized, and its biopsy specimen showed adenocarcinoma. The patient underwent right lobectomy and biliary reconstruction. The pathological diagnosis was intraductal papillary neoplasm with high-grade intraepithelial neoplasia, pTis, pN0, pStage 0. The patient’s postoperative course was uneventful, and he has had no recurrence up to the present time. CONCLUSION: This case suggests the necessity of careful observation after flow diversion surgery, especially when PBM with CBD is detected in adulthood.
Rights: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
URI: http://hdl.handle.net/2433/251037
DOI(Published Version): 10.4254/wjh.v11.i11.743
PubMed ID: 31772721
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