A Case of Congenital Biliary Dilatation Associated with Bile Duct Carcinoma and Pancreatic Stones

Saiho Ko, Syusaku Yoshikawa, Yoshiki Hata, Masami Yagi, Yoshiyuki Nakajima*, Hiroshige Nakano*

Department of Surgery, Nara Prefectural Mimuro Hospital
*First Department of Surgery, Nara Medical University

A 35-year-old man was admitted to our hospital complaining of upper abdominal pain and nausea. His condition was diagnosed as congenital biliary dilatation (Alonso-Lej I type) associated with a common bile duct tumor and pancreatic stones, and pancreaticoduodenectomy was performed. The common bile duct showed cystic dilation (5.5 cm in diameter). A villous tumor (15×15×5 mm) in the dilated common bile duct, and 4 pancreatic stones in the main pancreatic duct were found. An anomalous arrangement of the pancreaticobiliary duct system was observed. Histological examination of the tumor revealed a papillary adenocarcinoma confined to the fibromuscular layer with no metastasis. Biliary carcinoma in congenital biliary dilatation is frequently detected only in the advanced stage, and its prognosis is poor. Many cases of early carcinoma such as this case should be studied to clarify the characteristics of carcinoma in congenital biliary dilatation.

Key words
congenital biliary dilatation, bile duct carcinoma, pancreatic stones

Reprint requests
Saiho Ko Department of Surgery, Nara Prefectural Mimuro Hospital
1-14-16 Mimuro, Sango-cho, Ikoma-gun, Nara, 636 JAPAN

Accepted
January 16, 1991

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