Scientific PapersLate bile duct cancer complicating biliary-enteric anastomosis for benign disease
Section snippets
Clinical material
Three female patients who had undergone biliary-enteric anastomosis for iatrogenic bile duct injury many years before presented with biliary tract problems without preceding clinical or biochemical evidence to suggest an anastomotic stricture. The Table 1summarizes the relevant details of the 3 patients. Each biliary-enteric anastomosis was patent on preoperative investigations and confirmed on the resected specimen in patients 1 and 2, in whom radical choledochectomy and liver resection were
Comments
The occurrence of cholangiocarcinoma of the bile ducts following long-term choledocho-enteric anastomosis may have been purely coincidental but raises the possibility that direct connection between the intestinal tract and biliary tree could be a predisposing factor. There have been three reports of cholangiocarcinoma as a late complication of choledocho-enteric anastomosis for benign disease where a premalignant process was not evident.1, 2, 3 The malignancy developed 9 to 17 years after
References (17)
Occurrence of an adenocarcinoma at the choledochoenteric anastomosis 14 years after pancreatoduodenectomy for benign disease
Gastroenterology
(1977)- et al.
Late development of bile duct cancer after sphincteroplastya ten to twenty-two year follow-up study
Surgery
(1997) - et al.
Relation of patient age to premalignant alterations in choledochal cyst epithelium
J Pediatr Surg
(1986) - et al.
Occurrence of an intrapancreatic choledochal carcinoma 9 years after choledochojejunostomy for benign disease
Jpn J Cancer Clin
(1983) - et al.
Cholangiocarcinoma as a late complication of choledochoenteric anastomoses
Am J Radiol
(1986) - et al.
Late development of cholangiocarcinoma after the treatment of hepatolithiasis
Surg Gynecol Obstet
(1993) - et al.
Population-based study of cancer risk and relative survival following sphincterotomy for stones in the common bile duct
Br J Surg
(1997) - et al.
Carcinoma related to choledochal cysts with internal drainage operations
Surg Gynecol Obstet
(1987)
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