Recurrent ascending cholangitis secondary to food reflux following transduodenal resection of an ampullary adenoma

Fouad, Mina; James, Martin W; Zaitoun, Abed M; Hanks, Matthew; Lobo, Dileep N

Abstract

Ampullary lesions, including adenomas and early-stage carcinomas, pose a diagnostic and therapeutic challenge due to their location and proximity to the pancreatic and bile ducts. Transduodenal ampullectomy offers a targeted approach for the resection of these lesions while preserving the integrity of the pancreaticobiliary system. Moreover, transduodenal ampullectomy is associated with favorable postoperative outcomes, including low rates of morbidity and mortality, as well as preservation of pancreatic and biliary function. However, potential complications such as ascending cholangitis pancreatic leakage, bleeding, and duodenal stenosis can occur which would impact the postoperative quality of life. Addressing these outcomes might require either endoscopic procedures or surgical interventions. We present an exceedingly uncommon case of recurrent ascending cholangitis resulting from reflux of food particles into the common bile duct that was treated successfully with a Roux-en-Y hepaticojejunostomy and gastroenterostomy.

Citation

Fouad, M., James, M. W., Zaitoun, A. M., Hanks, M., & Lobo, D. N. (2025). Recurrent ascending cholangitis secondary to food reflux following transduodenal resection of an ampullary adenoma. Annals of The Royal College of Surgeons of England, https://doi.org/10.1308/rcsann.2024.0110

• Journal Article Type: Article
• Acceptance Date: Nov 15, 2024
• Online Publication Date: Mar 25, 2025
• Publication Date: Mar 25, 2025
• Deposit Date: Nov 21, 2024
• Publicly Available Date: Mar 27, 2025
• Journal: Annals of The Royal College of Surgeons of England
• Print ISSN: 0035-8843
• Electronic ISSN: 1478-7083
• Publisher: Royal College of Surgeons of England
• Peer Reviewed: Peer Reviewed
• DOI: https://doi.org/10.1308/rcsann.2024.0110
• Keywords: Ampulla of Vater; transduodenal ampullectomy; recurrent cholangitis; biliary lithiasis; food reflux
• Public URL: https://nottingham-repository.worktribe.com/output/42214035
• Publisher URL: https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2024.0110