Abstract
We report a case of abdominal pain associated with the intrapancreatic residual bile duct (BD) after an operation of anomalous arrangement of the pancreaticobiliary duct (AAPBD). A 36-year-old man, who had undergone a cholecystectomy and partial resection of the extrahepatic BD with hepaticojejunostomy for AAPBD with dilated BD, had occasional abdominal pain after the operation. We conducted a total resection of the intrapancreatic residual BD under a diagnosis of intrapancreatic residual cholangitis. We exfoliated the intrapancreatic residual BD to the confluence of the pancreatic and BD in the pancreas, which was completely resected after ligation of the BD terminal. There have been many reports referring to malignant changes of intrahepatic residual BD after an initial operation for AAPBD. Therefore, complete resection of the extrahepatic BD, including the intrapancreatic region is essential in the operation for AAPBD. Moreover, when the residual BD in the pancreas is found, reoperation for complete resection of the BD should be considered.
