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Cholangiocarcinoma arising after biliary-enteric drainage procedures for benign disease
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  1. V Bettschart1,
  2. R A E Clayton1,
  3. R W Parks1,
  4. O J Garden1,
  5. C O C Bellamy2
  1. 1Department of Clinical and Surgical Sciences (Surgery), University of Edinburgh and Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
  2. 2Department of Pathology, University of Edinburgh and Scottish Liver Transplant Unit, Royal Infirmary of Edinburgh, Edinburgh, UK
  1. Correspondence to:
    V Bettschart, Department Surgery, University Of Edinburgh, Royal Infirmary of Edinburgh, Lauriston Place, Edinburgh EH3 9YW, UK;
    V.Bettschart{at}ed.ac.uk

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BACKGROUND

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.

AIMS

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.

PATIENTS

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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