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Pancreatobiliary maljunction: association with gallbladder cancer
Marta Garzón Benavides1, Andrea Núñez Ortiz2, Teófilo López Ruiz3
1Department of Gastroenterology. Hospital Virgen, Hospital Universitario Virgen del Rocío, Spain.
Revista Espanola De Enfermedades Digestivas
|June 20, 2019
Summary
Pancreatobiliary maljunction increases the risk of gallbladder and biliary tract cancers. Early prophylactic intervention is recommended for patients with this condition, even if asymptomatic, to prevent malignancy.
Area of Science:
- Gastroenterology
- Surgical Oncology
Background:
- Pancreatobiliary maljunction (PBM) is a rare congenital anomaly where pancreatic and bile ducts join outside the duodenal wall.
- This anatomical variation leads to a large common channel, increasing the risk of pancreatitis and biliary tract cancers.
Observation:
- A 43-year-old female with PBM presented with bile duct stenosis post-acute pancreatitis.
- Despite multiple endoscopic retrograde cholangiopancreatography (ERCP) treatments, stenosis persisted, necessitating surgery.
- Preoperative MRI revealed an 11-mm gallbladder polyp.
Findings:
- Histological examination of the surgical specimen confirmed intramucosal adenocarcinoma arising from a gallbladder tubular adenoma.
- This case highlights the association between PBM and gallbladder neoplasia.
Implications:
- Pancreatobiliary maljunction is considered a premalignant condition due to its association with biliary and gallbladder cancers.
- Prophylactic surgical intervention should be considered for patients with PBM, irrespective of symptoms, to mitigate cancer risk.
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