Gallbladder cancer 20 years after surgery for duodenal atresia with biliary anomalies

Abstract

The prognosis for duodenal atresia (DA) is generally good if radical surgery is performed. However, some cases of DA may be complicated by morphological abnormalities in the pancreaticobiliary system, which may cause problems in the distant period. Here, we report a case of gallbladder cancer (GC) that developed more than 20 years after the initial DA operation. A female infant was admitted to our institution with an anorectal malformation after birth. She had Down syndrome, a ventricular septal defect, and DA. She underwent duodenoduodenostomy for DA, during which a Y-shaped biliary duct was found. The patient grew up well postoperatively, and she was followed up at our institution until the age of 12 years. At the age of 24, she was reintroduced to our institution for multiple hepatic tumors and was diagnosed with GC and multiple liver metastases. Simultaneously, a pancreaticobiliary maljunction (PBM) without a choledochal cyst was also identified. She received palliative care and died two months later. Although reports of combined DA and PBM are rare, the combination should not be overlooked, given the carcinogenic risk of PBM. DA with pancreaticobiliary anomalies requires attention to the possibility of PBM during the postoperative follow-up.

Keywords

• Duodenal atresia
• Gallbladder cancer
• Pancreaticobiliary maljunction