Abstract
A case of cancer of the papilla of Vater in which obstructive jaundice developed one year after total gastrectomy for early stomach cancer is reported.
A 51-year-old woman underwent total gastrectomy because of early stomach cancer. She developed obstructive jaundice one year after the gastrectomy and underwent internal bile drainage. At that time, a tumor of the papilla of Vater was noticed. Abdominal ultrasonography and computed tomography revealed no tumor in the biliary tract or pancreas. On cholangiograms, the biliary tract was compressed at its duodenal end by an extra-biliary tumor. Pancreatoduodenectmy was carried out. The biliary tract and pancreatic duct ended separately in the same papilla. A 10×10×4 mm ulcerating white tumor which encircled the orifice of the pancreatic duct was noted. Histologically, the tumor was moderately differentiated tubular adenocarcinoma.
In cases with obstructive jaundice after gastrectomy who show no sign of unresectability, reoperation should be considered even if the diagnosis can not be made.
