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HPB Surgery
Volume 6 (1993), Issue 3, Pages 211-217
Case Report

Papillo-Choledochectomy in the Operative Management of Mucosal Neoplasms of the Periampullary Region

Departments of Surgery and Pathology, Jichi Medical School, Minami-kawachimachi, Tochigi, 329–04, Japan

Received 28 January 1992; Accepted 31 March 1992

Copyright © 1993 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Two patients with mucosal cancer of the periampullary region were treated with papillocholedochectomy, which entails removal of the papilla of Vater and the whole length of the common bile duct. The neoplasm is dissected out through the plane between the duodenal circular and longitudinal muscles, deep to the sphincter of Oddi and the fibromuscular layer of the bile duct. Pathological examination showed that cancer was confined to the mucosal layer without stromal invasion, and that the operation achieved radical cure. For mucosal cancer, papillo-choledochectomy is an alternative to pancreatoduodenectomy, provided that repeated frozen-section studies confirm the completeness of excision.