부산대학교 도서관

A rare case of cystic dilatation of the intrapancreatic bile duct, not a form of choledochocele, is presented. The case was 34 years old male complaining epigastralgie. ERCP revealed cystic dilatation of the intrapancreatic bile duct with no protrusion into the duodenal lumen. The existence of anomalous arrangement of the pancreaticobiliary duct system was also strongly suggested. Excision of the intrapancreatic bile duct along with the extrapancreatic common bile duct and the gall bladder was performed followed by the reconstruction with end-to-side choledocho-duodenostomy.The histological examination of the resected specimen revealed that the existence of intestinal metaplasia in the choledochal cyst epithelium, which might be pre-malignant condition of choledochal carcinoma. The amylase value of the bile in the gall bladder was extremely high (67,100unit), which was considered to suggest the existence of the anomalous arrangement of the pancreaticobiliary duct system.Post-operative course was uneventful, and sustained no reflux cholangitis.