Other tumor sites included the rectum, the pancreas, the ampulla of Vater, the sigmoid colon, and the ductus choledochus
. The adenocarcinoma component was well-differentiated in six patients, medium-differentiated in three patients, and low-differentiated in one patient.
2) were preformed, which verified choledochal cyst of the distal part of the choledochus
, of approximately 4 cm in size, with its top communicating with the small intestine.
Choledochal cyst: complications of anomalous connection between the choledochus
and pancreatic duct and carcinoma of the biliary tract.
The main pancreatic duct merges with the ductus choledochus
and opens into the major papilla region of the duodenum (1, 3, 11, 19, 20).
Ultrasonography confirmed the suspected diagnosis of cholangitis: enlargement of the choledochus
(12 mm), occluded in its distal part by a 9 mm lithiasis.
Beger procedure was performed with jejunal Roux-en-Y loop which drained the residual pancreas via an end-to-end or end-to-side pancreaticojejunostomy to the body of the pancreas and a side-to-side pancreaticojejunostomy to the excavated pancreatic head remnant and opening intrapancreatic choledochus
and suturing the incision to bilateral pancreas tissues.
It is feasible to suggest that periampullary diverticuli deteriorate the evacuative function of the bile duct due to compression of terminal parts of the choledochus