Carcinoma of the papilla of Vater following treatment of pancreaticobiliary maljunction.

Pancreaticobiliary maljunction (PBM) is frequently associated with biliary cancer due to reflux of pancreatic enzymes into the choledochus, and even after surgery to correct the PBM such patients still have a risk of residual bile duct cancer. Here, we report the case of a 59-year-old female with carcinoma of the papilla of Vater which developed 2.5 years after choledochoduodenostomy for PBM. During the postoperative follow-up period, computed tomography obtained 2 years after the first operation demonstrated a tumor in the distal end of the choledochus, although she did not have jaundice and laboratory tests showed no abnormalities caused by the previous operation. As a result, carcinoma of the papilla of Vater was diagnosed at an early stage, followed by surgical cure. For early detection of periampullary cancer in patients undergoing surgery for PBM, careful long-term follow-up is needed.

[1]  Masahiro Yoshida,et al.  Risk factors for biliary tract and ampullary carcinomas and prophylactic surgery for these factors , 2008, Journal of hepato-biliary-pancreatic surgery.

[2]  A. Ishihara,et al.  Bile duct schwannoma developed in the remnant choledochal cyst-a case associated with total agenesis of the dorsal pancreas. , 2005, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[3]  K. Hatakeyama,et al.  Jaundice at Presentation Heralds Advanced Disease and Poor Prognosis in Patients with Ampullary Carcinoma , 2005, World Journal of Surgery.

[4]  W. Kimura,et al.  Neoplastic diseases of the papilla of Vater. , 2004, Journal of hepato-biliary-pancreatic surgery.

[5]  H. Shimada,et al.  Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan. , 2003, Journal of hepato-biliary-pancreatic surgery.

[6]  T. Ochiai,et al.  Risk of bile duct carcinogenesis after excision of extrahepatic bile ducts in pancreaticobiliary maljunction. , 1999, Surgery.

[7]  A. Toki,et al.  Bile duct cancer developed after cyst excision for choledochal cyst. , 1999, Journal of hepato-biliary-pancreatic surgery.

[8]  D. Klimstra,et al.  Factors predictive of survival in ampullary carcinoma. , 1998, Annals of surgery.

[9]  K. Yamaguchi,et al.  Carcinoma of the pancreas associated with anomalous junction of pancreaticobiliary tracts: report of two cases and review of the literature. , 1998, Journal of hepato-biliary-pancreatic surgery.

[10]  H. Nagai,et al.  Malignant change in the biliary tract after excision of choledochal cyst , 1997, The British journal of surgery.

[11]  T. Maeba,et al.  Choledochal cyst, pancreatobiliary malunion, and cancer , 1994 .

[12]  Yinmo Yang,et al.  Carcinoma of the Ampulla of Vater: Factors Influencing Long-term Survival of 127 Patients with Resection , 2006, World Journal of Surgery.