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Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature

BACKGROUND: Pancreaticobiliary maljunction (PBM) can be classified into two categories, PBM with congenital biliary dilatation (CBD) or PBM without biliary dilatation, and the management of PBM is often controversial. The treatment for PBM with CBD is prophylactic flow diversion surgery, and some au...

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Autores principales: Ataka, Ryo, Ito, Takashi, Masui, Toshihiko, Seo, Satoru, Ishii, Takamichi, Ogiso, Satoshi, Yagi, Shintaro, Taura, Kojiro, Uemoto, Shinji
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856020/
https://www.ncbi.nlm.nih.gov/pubmed/31772721
http://dx.doi.org/10.4254/wjh.v11.i11.743
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author Ataka, Ryo
Ito, Takashi
Masui, Toshihiko
Seo, Satoru
Ishii, Takamichi
Ogiso, Satoshi
Yagi, Shintaro
Taura, Kojiro
Uemoto, Shinji
author_facet Ataka, Ryo
Ito, Takashi
Masui, Toshihiko
Seo, Satoru
Ishii, Takamichi
Ogiso, Satoshi
Yagi, Shintaro
Taura, Kojiro
Uemoto, Shinji
author_sort Ataka, Ryo
collection PubMed
description BACKGROUND: Pancreaticobiliary maljunction (PBM) can be classified into two categories, PBM with congenital biliary dilatation (CBD) or PBM without biliary dilatation, and the management of PBM is often controversial. The treatment for PBM with CBD is prophylactic flow diversion surgery, and some authors have reported that the incidence of cancer after extrahepatic bile duct excision is less than 1%. A very rare case of intrahepatic cholangiocarcinoma 6 years after flow diversion surgery for PBM with CBD is reported. CASE SUMMARY: A 30-year-old man was diagnosed as having PBM with CBD, Todani classification type IVA, because of abnormal liver enzyme profiles. He underwent flow diversion surgery and cholecystectomy, and the specimen showed adenocarcinoma foci, pT1, pStage IA. Five and a half years passed without any recurrence of bile duct cancer. However, 6 years after his operation, computed tomography showed a gradually growing nodule in the bile duct. Fluorodeoxyglucose positron emission tomography showed high uptake, and magnetic resonance imaging showed restricted diffusion signals. On double balloon enteroscopy, the nodule at the posterior bile duct-jejunum anastomosis was directly visualized, and its biopsy specimen showed adenocarcinoma. The patient underwent right lobectomy and biliary reconstruction. The pathological diagnosis was intraductal papillary neoplasm with high-grade intraepithelial neoplasia, pTis, pN0, pStage 0. The patient’s postoperative course was uneventful, and he has had no recurrence up to the present time. CONCLUSION: This case suggests the necessity of careful observation after flow diversion surgery, especially when PBM with CBD is detected in adulthood.
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spelling pubmed-68560202019-11-27 Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature Ataka, Ryo Ito, Takashi Masui, Toshihiko Seo, Satoru Ishii, Takamichi Ogiso, Satoshi Yagi, Shintaro Taura, Kojiro Uemoto, Shinji World J Hepatol Case Report BACKGROUND: Pancreaticobiliary maljunction (PBM) can be classified into two categories, PBM with congenital biliary dilatation (CBD) or PBM without biliary dilatation, and the management of PBM is often controversial. The treatment for PBM with CBD is prophylactic flow diversion surgery, and some authors have reported that the incidence of cancer after extrahepatic bile duct excision is less than 1%. A very rare case of intrahepatic cholangiocarcinoma 6 years after flow diversion surgery for PBM with CBD is reported. CASE SUMMARY: A 30-year-old man was diagnosed as having PBM with CBD, Todani classification type IVA, because of abnormal liver enzyme profiles. He underwent flow diversion surgery and cholecystectomy, and the specimen showed adenocarcinoma foci, pT1, pStage IA. Five and a half years passed without any recurrence of bile duct cancer. However, 6 years after his operation, computed tomography showed a gradually growing nodule in the bile duct. Fluorodeoxyglucose positron emission tomography showed high uptake, and magnetic resonance imaging showed restricted diffusion signals. On double balloon enteroscopy, the nodule at the posterior bile duct-jejunum anastomosis was directly visualized, and its biopsy specimen showed adenocarcinoma. The patient underwent right lobectomy and biliary reconstruction. The pathological diagnosis was intraductal papillary neoplasm with high-grade intraepithelial neoplasia, pTis, pN0, pStage 0. The patient’s postoperative course was uneventful, and he has had no recurrence up to the present time. CONCLUSION: This case suggests the necessity of careful observation after flow diversion surgery, especially when PBM with CBD is detected in adulthood. Baishideng Publishing Group Inc 2019-11-27 2019-11-27 /pmc/articles/PMC6856020/ /pubmed/31772721 http://dx.doi.org/10.4254/wjh.v11.i11.743 Text en ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial.
spellingShingle Case Report
Ataka, Ryo
Ito, Takashi
Masui, Toshihiko
Seo, Satoru
Ishii, Takamichi
Ogiso, Satoshi
Yagi, Shintaro
Taura, Kojiro
Uemoto, Shinji
Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title_full Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title_fullStr Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title_full_unstemmed Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title_short Cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: A case report and review of literature
title_sort cholangiocarcinoma after flow diversion surgery for congenital biliary dilatation: a case report and review of literature
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6856020/
https://www.ncbi.nlm.nih.gov/pubmed/31772721
http://dx.doi.org/10.4254/wjh.v11.i11.743
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