title: Multiple Cancers of the Biliary Tract and Pancreatic Duct after Cholecystectomy for Gallbladder Cancer in a Patient with Pancreaticobiliary Maljunction.
abstract: We herein report the rare case of a 76-year-old woman who underwent cholecystectomy with bile duct resection for advanced gallbladder cancer associated with pancreaticobiliary maljunction (PBM) and subsequently developed multiple cancers of the pancreaticobiliary system (the distal bile duct, intrahepatic duct and pancreatic duct) after the operation. We performed conventional endoscopic retrograde cholangiopancreatography (ERCP) using a side-viewing scope to evaluate the masses in the distal bile duct and the pancreatic duct. We also performed ERCP using double-balloon enteroscopy (DBE) to observe the mass in the intrahepatic duct. It was possible to directly observe the lesion using DBE and to perform a biopsy under visual control. All lesions were correctly diagnosed by the combination of ERCP using different endoscopes. The present case suggests that it is necessary to pay close attention (with regard to carcinogenesis) to the whole pancreaticobiliary system in patients with PBM. In addition, the combination of ERCP using DBE and a side-viewing scope may be useful for making a precise diagnosis in patients with altered biliary anatomy who have multiple cancers of the pancreaticobiliary system.
authors.affiliation: Gastroenterology Medicine Center, Shonan Kamakura General Hospital, Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Koizumi
authors.forename: Junpei
authors.initials: J
authors.lastname: Sasajima
authors.forename: Toru
authors.initials: T
authors.lastname: Kawamoto
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Sugiyama
authors.forename: Mizue
authors.initials: M
authors.lastname: Muto
authors.forename: Momotaro
authors.initials: M
authors.lastname: Muto
authors.forename: Chisato
authors.initials: C
authors.lastname: Ishikawa
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Inoue
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Kohgo
mesh_terms: D000368:Aged; D001652:Bile Ducts / Q000473:pathology*; D001659:Biliary Tract / Q000000981:diagnostic imaging / Q000473:pathology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D002763:Cholecystectomy; D058582:Double-Balloon Enteroscopy; D005260:Female; D005706:Gallbladder Neoplasms / Q000473:pathology* / Q000601:surgery*; D006801:Humans; D010183:Pancreatic Ducts / Q000473:pathology*