A case of distal bile duct cancer occurring 56 years after surgery for congenital biliary dilatation

Abstract

A 56-year-old woman was admitted to our hospital with jaundice. She had undergone surgery for congenital bile duct dilatation three months after birth, however, the details of the operation were unclear. Biliary drainage via endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessful, and percutaneous transhepatic biliary drainage (PTBD) was performed to manage the jaundice. She was diagnosed with distal bile duct cancer originating from the anastomotic site of the dilated biliary tract to the duodenum, which was created using a side-to-side technique (choledochoduodenostomy). A pancreaticoduodenectomy was chosen as the radical treatment. The postoperative histopathological examination confirmed the preoperative diagnosis at the anastomotic site.

Choledochoduodenostomy or choledochojejunostomy for congenital bile duct dilatation was once considered a standard treatment. However, due to the increasing risk of carcinogenesis associated with these procedures, diversion surgery has been recommended since 1990. This case underscores the importance of selecting the optimal surgical procedure and ensuring long-term follow-up after surgery for congenital bile duct dilatation.