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Retroduodenal resection of the extrahepatic common bile duct with in situ re-implantation of the main pancreatic duct: A report of two cases
Resection of the whole distal common bile duct (CBD) with in situ re-implantation of the main pancreatic duct can be a surgical option to avoid pancreaticoduodenectomy. in this study, we present two cases of cholangiocarcinomas with diffuse involvement of the extrahepatic CBD that was resected throu...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Association of Hepato-Biliary-Pancreatic Surgery
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7452793/ https://www.ncbi.nlm.nih.gov/pubmed/32843608 http://dx.doi.org/10.14701/ahbps.2020.24.3.373 |
Sumario: | Resection of the whole distal common bile duct (CBD) with in situ re-implantation of the main pancreatic duct can be a surgical option to avoid pancreaticoduodenectomy. in this study, we present two cases of cholangiocarcinomas with diffuse involvement of the extrahepatic CBD that was resected through a retroduodenal approach and re-implantation of the main pancreatic duct. The first case was a 70-year-old male patient with intraductal papillary neoplasm with invasive cholangiocarcinoma. He underwent retroduodenal resection of the whole CBD and in situ re-implantation of the main pancreatic duct. He was disease-free for 8 years, but tumor recurrence occurred at the hepaticojejunostomy site. This patient is currently undergoing chemoradiation therapy for treatment of recurrent lesions. The second case was a 71-year-old male patient with diffuse cholangiocarcinoma involving the whole extrahepatic CBD. He underwent medial sectionectomy, retroduodenal resection of the whole CBD and in situ re-implantation of the main pancreatic duct. He received postoperative chemoradiation therapy. He was disease-free for 3 years, but tumor recurrence occurred at the hepaticojejunostomy site. He passed away 4 years and 6 months after surgery. In conclusion, complete resection of the extrahepatic CBD through a retroduodenal approach with in situ re-implantation of the main pancreatic duct is feasible and less invasive than PD. Therefore, the proposed less-invasive approach can be an alternative procedure in selected patients requiring complete resection of the distal CBD. |
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