A case of intraductal papillary neoplasm of the bile duct concomitant with double common bile duct

Abstract

A 69-year old man visited a nearby hospital presenting with jaundice, epigastric pain, and fever. The delated two intrapancreatic bile ducts were detected, opening to the duodenal papilla. One of the double common bile ducts was packed with papillary tumor. The papillary orifice was dilated because of excessive production of mucin. We performed pancreatoduodenectomy. Histologically, columnar tumor cells with various degrees of atypia showed papillary growth within the dilated duct. The also tumor involved the main pancreatic duct. A final diagnosis of IPNB concomitant with double common bile duct was established. There is no report of patient with IPNB concomitant with double common bile duct. For the treatment of the double common bile duct, it is important to adequately classify the types of double common bile ducts and to know the co-morbidity of this rare variants, preoperatively.