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A long-term survival case of advanced biliary cancer with repeated resection due to recurrence in the pancreaticogastrostomy site after pancreaticoduodenectomy
Ann Hepatobiliary Pancreat Surg 2018 May;22(2):173-7
Published online May 31, 2018
Copyright © 2018 Ann Hepatobiliary Pancreat Surg.

Shohei Eto, Masashi Ishikawa, Michihito Asanoma, Yoshihiko Tashiro, Kazuo Matsuyama, and Takehito Oshio

Department of Surgery, Shikoku Central Hospital, Ehime, Japan
Received September 17, 2017; Revised January 10, 2018; Accepted January 14, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
A 62-year-old man underwent endoscopic mucosal resection for early gastric cancer. The follow-up computed tomog-raphy revealed biliary dilatation. The tumor was located in the lower bile duct with biliary dilatation, and no evidence of metastasis in other organs was noted. The patient underwent subtotal stomach-preserving pancreatoduodenectomy with pancreaticogastrostomy and Billroth I anastomosis. At 13 months after the operation, gastrointestinal endoscopy revealed a tumor lesion in the pancreaticogastrostomy site. Computed tomography revealed that the lesion was low enhanced in the pancreaticogastrostomy site and there was no evidence of other distant metastasis. Partial pan-createctomy was performed. Pathological findings of the tumor in the stump of the pancreas revealed findings similar to that of primary biliary carcinoma. Apparently, the patient was diagnosed with recurrence of bile duct cancer via the pancreatic duct. The patient underwent adjuvant chemotherapy for one year subsequent to partial pancreatectomy as the second operation. For 40 months after the second operation, there has been no evidence of recurrence of cancer. (Ann Hepatobiliary Pancreat Surg 2018;22:173-177)
Keywords : Biliary cancer; Surgery; Recurrence; Pancreaticoduodenectomy; Pancreaticogastrostomy


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