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A new variant of bile duct duplication with coexistence of distal cholangiocarcinoma

Nature Reviews Gastroenterology & Hepatology volume 7, pages 527–530 (2010)Cite this article

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Abstract

Background. A 72-year-old hypertensive woman presented with a 2-month history of right upper quadrant abdominal pain. She had a 15-day history of jaundice, fever with chills and shivering, nausea, vomiting, weight loss and generalized pruritus.

Investigations. Physical examination, laboratory evaluation, transabdominal ultrasonography, magnetic resonance cholangiopancreatography, endoscopic retrograde cholangiopancreatography, brush cytology, laparotomy and histopathology.

Diagnosis. Bile duct duplication with coexistence of distal cholangiocarcinoma.

Management. En bloc resection (including the duodenum, pancreatic head and adjacent lymph nodes), hepaticojejunostomy and pylorus-saving Whipple operation.

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Figure 1: Duplication of the common bile duct in the case patient.
Figure 2: Histopathological evaluation of surgical specimens from the case patient.
Figure 3: Modified classification system of duplicated extrahepatic bile ducts as proposed by Choi et al.7
Figure 4: The anatomical variant in the case patient.

References

  1. Mortele, K. & Ros, P. R. Anatomic variants of the biliary tree: MR cholangiographic findings and clinical applications. AJR Am. J. Roentgenol. 177, 389–394 (2001).

    Article  CAS  PubMed  Google Scholar 

  2. Kocaoglu, M., Ugurel, M. S., Bulakbasi, N. & Somuncu, I. MR cholangiography of a case with a biliary tract variation and postoperative biliary duct injury. Diagn. Interv. Radiol. 11, 219–221 (2005).

    PubMed  Google Scholar 

  3. Taourel, P., Bret, P. M., Reinhold, C., Barkun, A. N. & Atri, M. Anatomic variants of the biliary tree: diagnosis with MR cholangiopancreatography. Radiology 199, 521–527 (1996).

    Article  CAS  PubMed  Google Scholar 

  4. Yamashita, K. et al. Double common bile duct: a case report and a review of the Japanese literature. Surgery 131, 676–681 (2002).

    Article  PubMed  Google Scholar 

  5. Catalano, O. A. et al. Vascular and biliary variants in the liver: implications for liver surgery. Radiographics 28, 359–378 (2008).

    Article  PubMed  Google Scholar 

  6. Bayraktar, Y., Balaban, H. Y., Arslan, S. & Balkanci, F. Agenesis of gallbladder and multiple anomalies of the biliary tree in a patient with portal thrombosis: a case report. Turk. J. Gastroenterol. 17, 212–215 (2006).

    PubMed  Google Scholar 

  7. Choi, E., Byun, J. H., Park, B. J. & Lee, M. G. Duplication of the extra hepatic bile duct with anomalous union of the pancreaticobiliary ductal system revealed by MR cholangiopancreatography. Br. J. Radiol. 80, e150–e154 (2007).

    Article  CAS  PubMed  Google Scholar 

  8. Djuranovic, S. P. et al. Double common bile duct: a case report. World J. Gastroenterol. 13, 3770–3772 (2007).

    Article  PubMed  PubMed Central  Google Scholar 

  9. Kim, S. W. et al. Duplication of the extrahepatic bile duct in association with choledocholithiasis as depicted by MDCT. Korean J. Radiol. 9, 550–554 (2008).

    Article  PubMed  PubMed Central  Google Scholar 

  10. Hashimoto, M. et al. Double hepatic duct associated with anomalous pancreatobiliary ductal junction. Am. J. Surg. 187, 433 (2004).

    Article  PubMed  Google Scholar 

  11. Vauthey, J. N. & Blumgart, L. H. Recent advances in the management of cholangiocarcinomas. Semin. Liver Dis. 14, 109–114 (1994).

    Article  CAS  PubMed  Google Scholar 

  12. Yamamoto, T. et al. Education and imaging. Hepatobiliary and pancreatic: cholangiocarcinoma in a double bile duct. J. Gastroenterol. Hepatol. 21, 1859 (2006).

    Article  CAS  PubMed  Google Scholar 

  13. Wakai, T., Shirai, Y., Moroda, T. Yokoyama, N. & Hatakeyama, K. Impact of ductal resection margin status on long-term survival in patients undergoing resection for extrahepatic cholangiocarinoma. Cancer 103, 1210–1216 (2005).

    Article  PubMed  Google Scholar 

  14. Veillette, G. & Castillo, C. F. Distal biliary malignancy. Surg. Clin. North Am. 88, 1429–1447 (2008).

    Article  PubMed  Google Scholar 

  15. Wise, C. et al. Mechanisms of biliary carcinogenesis and growth. World J. Gastroenterol. 14, 2986–2989 (2008).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  16. Sica, G. T. et al. Comparison of endoscopic retrograde cholangiopancreatography with MR cholangiopancreatography in patients with pancreatitis. Radiology 210, 605–610 (1999).

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

Written consent for publication was obtained from the patient's responsible relative.

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Authors and Affiliations

  1. Department of Anatomy, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey

    Ilkay Kosar

  2. Department of Gastroenterology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey

    Hilmi Ataseven, Özlem Yönem & Erol Çakmak

  3. Department of General Surgery, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey

    Özdemir Özer & Ömer Topçu

  4. Department of Pathology, Cumhuriyet University School of Medicine, 58140, Sivas, Turkey

    Hatice Özer

Authors
  1. Ilkay Kosar
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Contributions

I. Kosar researched data for the article and contributed to discussing content, writing and reviewing the article. H. Ataseven researched data and contributed to discussion of the content of the article. Ö. Yönem contributed to the writing of the article. E. Çakmak researched data for the article. O. Özer and Ö. Topçu both provided substantial contribution to discussion of the content of the article. H. Özer was involved in reviewing/editing the article before submission.

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Correspondence to Hilmi Ataseven.

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The authors declare no competing financial interests.

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Kosar, I., Ataseven, H., Yönem, Ö. et al. A new variant of bile duct duplication with coexistence of distal cholangiocarcinoma. Nat Rev Gastroenterol Hepatol 7, 527–530 (2010). https://doi.org/10.1038/nrgastro.2010.118

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