A Case of Distal Bile Duct Cancer Associated with Preduodenal Portal Vein, Preduodenal Common Bile Duct, and Intestinal Malrotation

Abstract

A 78-year-old man who visited a neighboring hospital because of jaundice was referred to our hospital. Preoperative imaging diagnosis was distal bile duct cancer associated with preduodenal portal vein, intestinal malrotation, left side gallbladder, and preduodenal common bile duct.
Pancreaticoduodenectomy was performed. It was clarified that the portal vein, the right hepatic artery, and the common bile duct had pursued on the anterior aspect of the duodenum, concomitant pancreatitis was associated, and the tumor was easily bleeding. We dissected surroundings of the portal vein and right hepatic artery, pulled out the pancreas to the left side, transected the pancreas, and removed the surgical specimen. The postoperative course was uneventful, and he was discharged from the hospital on the 11^th postoperative day.
The patients with bile duct cancer who have unnatural run of the portal vein can also have other developmental anomalies like in our case. Preoperative diagnosis is important and careful operative procedures are crucial for them.