Palliative cholangiojejunostomy for refractory biliary obstruction in mucinous cholangiocarcinoma: a case report

Mucinous cholangiocarcinoma is a rare, aggressive biliary tract malignancy. Excessive mucin secretion causes diagnostic and therapeutic challenges. A 76-year-old male presented with painless progressive jaundice. Imaging showed cystic lesions with calcification in the right liver/hilum, intrahepatic bile duct dilation, and stones. Radical resection was deemed unfeasible due to insufficient predicted residual liver volume. Given the high risk of mucin-induced obstruction with conventional biliary drainage, palliative choledochojejunostomy was performed. Intraoperative findings revealed mucin and stones; frozen section pathology confirmed biliary mucinous adenocarcinoma. Postoperatively, bilirubin decreased significantly and biliary dilation improved. Mucinous cholangiocarcinoma management requires a multidisciplinary approach. When radical resection is contraindicated, palliative choledochojejunostomy effectively relieves mucin-related obstruction. Long-term outcomes depend on adjuvant therapy and surveillance; further, molecular research is needed to develop targeted therapies.