Abstract
A 24-year-old woman was referred to our hospital for relapsing pancreatitis after extrahepatic bile duct excision and Roux-Y hepatico-jejunostomy for anomalous arrangement of the pancreaticobiliary ductal system. Ultrasonography and Endoscopic ultrasonography revealed remnant choledocal cyst and a stone (7 mm in diameter) in the cyst. Endoscopic retrograde cholangiopancreatography revealed anomalous arrangement of the pancreaticobiliary ductal system associated with complicated anomaly of the pancreatic duct. Pylorus-preserving pancreatoduodenectomy was performed and the postoperative course of 3 years was uneventful.
We studied reasons for making choice of each operation for anomalous arrangement of the pancreaticobiliary ductal system which performed resection of pancreas head in 18 patients. The result suggest that the reasons classified into 3 groups as follows,1) pancreatic stones difficult to remove other methods,2) complicated anomaly of the pancreatic duct,3) choledocal cyst difficult to excise completely or remnant choledocal cyst after extrahepatic bile duct excision.
