Objective:

To report a case of hilar cholangiocarcinoma occurring 9 years after pancreaticoduodenectomy and to discuss the potential role of a migrated pancreaticojejunal stent in its development.

Approach:

Key Findings:

• The patient developed hilar cholangiocarcinoma 9 years after a Whipple procedure.
• Intraoperative exploration revealed migration of the internal pancreaticojejunostomy stent adjacent to the biliary-enteric anastomosis.
• Immunohistochemical analysis indicated a sporadic origin of the cholangiocarcinoma.

Interpretation:

The case highlights the need to consider second primary malignancies in patients with late-onset biliary obstruction after pancreaticoduodenectomy, particularly in the context of stent migration.

Limitations:

• The case is a single report and may not be generalizable.
• Long-term effects of indwelling stents on carcinogenesis require further investigation.

Conclusion:

The migrated pancreatic stent may have acted as a chronic irritant, potentially contributing to carcinogenesis in the biliary tract.

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