Skip to main content
Log in

Local recurrence at hepaticojejunostomy 9 years after resection of bile duct cancer with superficial flat spread

  • Published:
Journal of Hepato-Biliary-Pancreatic Surgery


We report a male patient aged 45 years, who in 1993 had been diagnosed as having middle bile duct cancer and had received a pancreatoduodenectomy. Histopathology showed a nodular tumor with the main lesion in the middle bile duct and superficial spreading in both proximal and distal directions (which was not observed macroscopically), and residual tumor in the epithelium of the cut edge near the liver. The patient underwent follow-up without postoperative adjuvant therapy. In 2002, 9 years after the operation, the patient developed jaundice and was diagnosed with recurrence of bile duct cancer in the anastomotic site, based on cholangiographic results. He underwent resection of the right hepatic and caudate lobes and the anastomotic region of the bile duct and jejunum. Pathological findings showed an invasive tumor in the anastomotic region, with continuous intraepithelial spread in the direction of the bile duct, which suggested that the residual tumor in the epithelium had grown to become an invasive cancer. In this patient, the recurrence required 9 years after resection. This case provides evidence for the clinical course that might be anticipated for a patient with a residual tumor in the epithelium of the bile duct stump and subsequent superficial spreading bile duct cancer.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. E Sakamoto Y Nimura N Hayakawa J Kamiya S Kondo M Nagino et al. (1998) ArticleTitleThe pattern of infiltration at the proximal border of hilar bile duct carcinoma: a histologic analysis of 62 resected cases Ann Surg 227 405–11 Occurrence Handle9527064 Occurrence Handle1:STN:280:DyaK1c7os1aqsQ%3D%3D Occurrence Handle10.1097/00000658-199803000-00013

    Article  PubMed  CAS  Google Scholar 

  2. E Sakamoto H Hasegawa S Ogiso T Igami T Mori T Mizuno et al. (2003) ArticleTitleStudy on the positive resected margin of the bile duct cancer (in Japanese with English abstract) Tando (J Jpn Biliary Assoc) 17 32–7

    Google Scholar 

  3. B Launois R Reding G Lebeau JL Buard (2000) ArticleTitleSurgery for hilar cholangiocarcinoma: French experience in a collective survey of 552 extrahepatic bile duct cancers J Hepatobiliary Pancreat Surg 7 128–34 Occurrence Handle10982604 Occurrence Handle1:STN:280:DC%2BD3cvotFyrtA%3D%3D Occurrence Handle10.1007/s005340050166

    Article  PubMed  CAS  Google Scholar 

  4. T Sano J Kamiya M Nagino K Uesaka S Kondo M Kanai et al. (1999) ArticleTitleMacroscopic classification and preoperative diagnosis of intrahepatic cholangiocarcinoma in Japan J Hepatobiliary Pancreat Surg 6 101–7 Occurrence Handle10398895 Occurrence Handle1:STN:280:DyaK1MzivFemug%3D%3D Occurrence Handle10.1007/s005340050091

    Article  PubMed  CAS  Google Scholar 

  5. T Wakai Y Shirai T Moroda N Yokoyama K Hatakeyama (2005) ArticleTitleImpact of ductal resection margin status on long-term survival in patients undergoing resection for extrahepatic cholangiocarcinoma Cancer 103 1210–16 Occurrence Handle15685618 Occurrence Handle10.1002/cncr.20906

    Article  PubMed  Google Scholar 

  6. S Kondo S Hirano Y Ambo E Tanaka S Okushiba T Morikawa et al. (2004) ArticleTitleForty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins: results of a prospective study Ann Surg 240 95–101 Occurrence Handle15213624 Occurrence Handle10.1097/01.sla.0000129491.43855.6b

    Article  PubMed  Google Scholar 

  7. N Tanaka M Nobori T Kohzuma Y Suzuki S Saiki (1994) ArticleTitleAnastomotic recurrence at hepaticojejunostomy in a long-term survivor of bile duct carcinoma: report of a case Surg Today 24 280–4 Occurrence Handle8003873 Occurrence Handle1:STN:280:ByuB2s3itFM%3D Occurrence Handle10.1007/BF02032903

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations


About this article

Cite this article

Sasaki, T., Kondo, S., Ambo, Y. et al. Local recurrence at hepaticojejunostomy 9 years after resection of bile duct cancer with superficial flat spread. J Hepatobiliary Pancreat Surg 13, 458–462 (2006).

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI:

Key words