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Although choledochoduodenostomy was widely performed for choledocholithiasis in the 1960s and 1970s, Roux-en-Y hepaticojejunostomy is currently the preferred biliary-enteric anastomosis for benign and malignant disease and is generally considered a low risk procedure, aside from the potential for cholangitis.
We report three cases referred over a 12 month period in which cholangiocarcinoma developed after previous biliary-enteric anastomosis, and review the literature to determine the likelihood of an association.
Case No 1
A 51 year old female developed obstructive jaundice 26 years after choledochoduodenostomy for a biliary stricture after iatrogenic bile duct injury. Endoscopic retrograde cholangiopancreatography (ERCP) showed neoplastic infiltration at the level of the anastomosis, biopsy of which revealed cholangiocarcinoma …
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