Choledochocele associated with superficial spreading bile duct cancer

Abstract

A 68-year-old woman was admitted to our hospital with acute cholangitis. Duodenoscopy demonstrated bulla like bulging of the oral side protrusion of the papilla of Vater. Endoscopic retrograde cholangiopancreatography (ERCP) revealed intermittent cystic dilatation and contraction of the terminal bile duct as well as irregularity of the wall from the lower to the upper portion of the bile duct. A diagnosis of choledochocele associated with superficial spreading cancer of the bile duct was made based on findings of peroral cholangioscopy (POCS) and transpapillary biopsy under direct vision and fluoroscopic guidance. The amylase level in bile sampled in the upper bile duct was 2217 IU/l. There is a possibility that reflux of pancreatic juice into the bile duct influenced the development of bile duct cancer.