A Case of Carcinoma of the Inferior Portion of the Bile Duct with a Choledocal Stone Which Occurred about 12 Years after Papilloplasty

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  • 経皮経肝胆道鏡検査で確認しえた再発総胆管結石を合併した乳頭括約筋形成術後の下部胆管癌の1例

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Abstract

We experienced a case of carcinoma of the inferior portion of the bile duct accompanied by a recurrent choledocal stone which occurred about 12 years after receiving transduodenal papilloplasty due to choledocholithiasis.<br> The patient was a 53-year-old man who underwent percutaneous transhepatic cholangioscopy (PTCS) because of the diagnosis of recurrent choledocholithiasis. PTCS revealed that a papillary protruding lesion was located at the inferior portion of the bile duct distal to the choledocal stone. Since the biopsied material demonstrated poorly differentiated adenocarcinoma, pylorus preserving pancreatoduodenectomy was performed.<br> Recently, endoscopic sphincterotomy has been actively adopted as a treatment for choledocholithiasis. However, it is unclear whether the incidence of biliary carcinoma increases after EST. There have been few reports about the cases of biliary carcinoma which generated after EST. We need the further course observation of the patients who underwent EST in order to see whether EST promotes the occurrence of biliary carcinoma or not.

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