Case Report
Copyright ©2009 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Dec 28, 2009; 15(48): 6126-6128
Published online Dec 28, 2009. doi: 10.3748/wjg.15.6126
Carcinoma of the papilla of Vater following treatment of pancreaticobiliary maljunction
Masato Watanabe, Yutaka Midorikawa, Taketoshi Yamano, Hiroyuki Mushiake, Naoto Fukuda, Takashi Kirita, Kunio Mizuguchi, Yasuyuki Sugiyama
Masato Watanabe, Yutaka Midorikawa, Taketoshi Yamano, Hiroyuki Mushiake, Naoto Fukuda, Yasuyuki Sugiyama, Department of Surgery, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki 213-8507, Japan
Takashi Kirita, Department of Surgery, Yokohama Shin-midori General Hospital, Yokohama 226-0025, Japan
Kunio Mizuguchi, Department of Pathology, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawasaki 213-8507, Japan
Author contributions: Watanabe M, Midorikawa Y, Mizuguchi K and Sugiyama Y wrote the paper; Kirita T identified and diagnosed the patient; Yamano T, Mushiake H and Fukuda N participated in the editing of the manuscript; all authors read and approved the final manuscript.
Supported by A Grant-in-Aid for Scientific Research (C), No. 19591601 (to Midorikawa Y)
Correspondence to: Yutaka Midorikawa, MD, Department of Surgery, Teikyo University School of Medicine University Hospital, 3-8-3 Mizonokuchi, Takatsu-ku, Kawasaki 213-8507, Japan. mido-tky@umin.ac.jp
Telephone: +81-44-8443333 Fax: +81-44-8443222
Received: July 28, 2009
Revised: August 25, 2009
Accepted: September 1, 2009
Published online: December 28, 2009
Abstract

Pancreaticobiliary maljunction (PBM) is frequently associated with biliary cancer due to reflux of pancreatic enzymes into the choledochus, and even after surgery to correct the PBM such patients still have a risk of residual bile duct cancer. Here, we report the case of a 59-year-old female with carcinoma of the papilla of Vater which developed 2.5 years after choledochoduodenostomy for PBM. During the postoperative follow-up period, computed tomography obtained 2 years after the first operation demonstrated a tumor in the distal end of the choledochus, although she did not have jaundice and laboratory tests showed no abnormalities caused by the previous operation. As a result, carcinoma of the papilla of Vater was diagnosed at an early stage, followed by surgical cure. For early detection of periampullary cancer in patients undergoing surgery for PBM, careful long-term follow-up is needed.

Keywords: Pancreaticobiliary maljunction; Biliary cancer; Carcinoma of the papilla of Vater