A case of resectable carcinoma arising in a choledochal cyst retained after three prior biliary drainage operations

Pancreatoduodenectomy was performed on a 34-year-old woman eho choledochal carcinoma arising in the choledochal cyst retained after three perior biliary drainage operations. Chemotherapy, immunotherapy and radiation were combined after surgery. Postoperative course was almost uneventful, and she has been doing well for the one and a half years since the operation. Carcinoma arises more occasionally and earlier in a choledochal cyst retained after enteris drainage than in a choledochal cyst without enteric drainage. Early resection of the extraphepatic biliary duct followed by billiary reconsrtuction for patients with enteric drainage apears to be essential. It is very rare for a patient with a congentital choledochal cyst to undergo four operations at four different times within a 32-years period. Although the prognosis of carcinoma arising in a choledochal cyst is very poor, she is in good health now, one and a half years after pancreatoduodenectomy.