Case Report
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World J Gastrointest Surg. Apr 27, 2010; 2(4): 143-146
Published online Apr 27, 2010. doi: 10.4240/wjgs.v2.i4.143
Metachronous cancer of gallbladder and pancreas with pancreatobiliary maljunction
Ahlem Lahmar, Sadri Ben Abid, Mohamed Nafaa Arfa, Rached Bayar, Mohamed Tahar Khalfallah, Sabah Mzabi-Regaya
Ahlem Lahmar, Sabah Mzabi-Regaya, Department of Pathology, Mongi Slim Hospital, 2046 Sidi-Daoued La Marsa, Tunis, Tunisia
Sadri Ben Abid, Mohamed Nafaa Arfa, Rached Bayar, Mohamed Tahar Khalfallah, Department of Surgery and Liver Transplantation, Mongi Slim Hospital, 2046 Sidi-Daoued La Marsa, Tunis, Tunisia
Author contributions: Abid SB and Bayar R wrote the manuscript; Arfa MN examined the past reference; Lahmar A performed the English editing; Khalfallah MT performed the operation surgery and Mzabi-Regaya S performed the histologic study; all authors contribuated to this work.
Correspondence to: Mohamed Nafaa Arfa, MD, Department of Surgery and Liver Transplantation, Mongi Slim Hospital, 2046 Sidi-Daoued La Marsa, Tunis, Tunisia. nafaa.arfa@rns.tn
Telephone: +216-70-939433 Fax: +216-70-939433
Received: October 9, 2009
Revised: January 28, 2010
Accepted: February 4, 2010
Published online: April 27, 2010
Abstract

Pancreaticobiliary maljunction is a congenital anomaly in which the junction between the pancreatic duct and the common bile duct is located outside the sphincter of Oddi. It is well known that pancreaticobiliary maljunction is frequently associated with carcinoma of the

biliary tract. We report a case of metachronous cancer of the gallbladder and pancreas associated with pancreaticobiliary maljunction and cystic dilatation of common bile duct in a 68-year-old Tunisian woman who underwent a cholecystectomy for acute cholecystitis. The pancreatic tumor was an adenosquamous carcinoma. Pancreaticobiliary maljunction allows for pancreatobiliary or biliopancreatic reflux which may induce biliary tract carcinoma. Few cases of multifocal cancer associated with this anomaly have been reported. The association with pancreatic carcinoma remains rare. Close attention should be given to both the biliary tract system and pancreas during the long-term follow-up of patients with pancreaticobiliary maljunction, especially after they have undergone a choledochojejunostomy.

Keywords: Pancreaticobiliary maljunction, Gallbladder cancer, Pancreatic cancer