Surgery Today

, Volume 44, Issue 5, pp 952–956

Hepatopancreatoduodenectomy for anastomotic recurrence from residual cholangiocarcinoma: report of a case

Authors

  • Seiji Natsume
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
  • Tomoki Ebata
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
  • Yukihiro Yokoyama
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
  • Tsuyoshi Igami
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
  • Gen Sugawara
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
  • Yu Takahashi
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
    • Division of Surgical Oncology, Department of SurgeryNagoya University Graduate School of Medicine
Case Report

DOI: 10.1007/s00595-013-0578-5

Cite this article as:
Natsume, S., Ebata, T., Yokoyama, Y. et al. Surg Today (2014) 44: 952. doi:10.1007/s00595-013-0578-5

Abstract

Resection of cholangiocarcinoma often results in a positive ductal margin, from carcinoma in situ (CIS) near the main tumor; however, the biological behavior of the residual CIS after surgical resection remains equivocal. We report a case of late local recurrence of CIS, defined as long-term tumor progression from CIS residue at the ductal stump. The patient, a 73-year-old man, had undergone bile duct resection for distal cholangiocarcinoma, leaving positive ductal margins with CIS. A biliary stricture was found 10 years later at the site of anastomosis, and right hepatectomy with pancreatoduodenectomy was performed. Based on histological analogy and the evidence of remnant CIS, a final diagnosis of late local recurrence from the CIS foci was made. This uncommon mode of recurrence should be considered in patients with early-stage disease with expected favorable survival because salvage surgery is feasible for selected patients.

Keywords

Anastomotic recurrenceCholangiocarcinomaCarcinoma in situ

Copyright information

© Springer Japan 2013