Abstract
A 55-year-old woman, who had previously undergone surgery for congenital biliary dilatation at the age of 8 years, had been suffering from recurrent right hypochondralgia with fever for the past year. Cholangitis was diagnosed and she was treated conservatively. However, her serum carcinoembryonic antigen level was elevated and computed tomography revealed a mass lesion in the pancreas head. She was therefore referred to our department for further evaluation and treatment. Percutaneous transhepatic biliary drainage was performed for obstructive jaundice, and a cholangiogram revealed bile duct cancer at the hepaticojejunostomy anastomotic site. She then underwent an internal drainage operation followed by pancreaticoduodenectomy. Macroscopically, an elevated lesion was observed in the inferior bile duct with invasion to the site of the hepaticojejunostomy and the parenchyma of the pancreas. A histological examination revealed moderately differentiated adenocarcinoma. Postoperative course was uneventful and she was discharged 30 days after the operation. She is doing well without any signs of recurrence at 4 years after the operation. We herein describe a rare case of bile duct cancer arising 47 years after an internal drainage operation for congenital biliary dilatation.
