Background : This study explores the feasibility and outcomes of surgical treatment of metachronous periampullary carcinoma following curative resection of the primary extrahepatic bile duct cancer. Reports on this secondary curative surgery are limited.

Methods : We retrospectively reviewed the medical records of seven patients who underwent pancreaticoduodenectomy (PD) for metachronous periampullary cancer following curative resection of extrahepatic bile duct cancer.

Results : The mean age of the seven patients at the time of second operation was 66.7 years (range, 43-81 years). The primary cancers were three hilar cholangiocarcinomas, one middle common bile duct cancers, and three gallbladder cancer. The metachronous cancers were three distal common bile duct cancers, three pancreas head cancers and one duodenal cancer. The mean interval between primary treatment and the diagnosis of metachronous periampullary cancer was 47 months (range, 13-121 months). There were no perioperative deaths. During the follow-up period, four patients died due to recurrence at 4,12,19, and 24 months postoperatively. One patients developed lung metastasis two months after PD and underwent VATS, this patients is still alive at 22 months. The remaining two patients are alive without recurrence at 38 and 92 months, respectively.

Conclusions : Based on the postoperative survival rate, PD may appears to be a feasible and effective option for patients with metachronous periampullary cancer following resection of extrahepatic bile duct cancer.