書誌事項
- タイトル別名
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- A CASE OF FAR ADVANCED GALL BLADDER CARCINOMA WITH INFERIOR BILIARY STRICTURE DUE TO MARKED TRANSMURAL AND LYMPHATIC SPREAD
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A 53-year-old female with obstructive jaundice was found in abdominal ultrasonography to have a papillary type lesion, about 4.5cm in diameter, with stones in the fundus and body of the peritoneal side of the gallbladder (GB). Enhanced CT demonstrated slightly enhanced homogeneous protruded lesion of the GB, swollen pancreas head (PH), and enhanced inferior-biliary duct with a wall thickness. MRCP showed distal stenosis of the lower bile duct. The patient was diagnosed with synchronous carcinoma of the GB and inferior bile duct and so underwent resection of the GB bed and extrahepatic bile duct and subtotal stomach preserving pancreatoduodenectomy. Histopathologic diagnosis of the gallbladder was poorly differentiated tubular adenocarcinoma with extensive spreading to the lymphatic canal and stroma, resulting in biliary stricture owing to marked transmural extension of the tumor and cancer positive cut margin of the left hepatic duct, anterior and posterior branch of the right hepatic duct, and the pancreas, whereas the mucosa of each biliary duct and MPD were not invaded. On the 62nd postoperative day, the patient died of the carcinomatosis. The autopsy revealed marked lymphatic and interstitial spread in several organs. It should be noted that the clinical strategy must be decided prudently because of the diffuculty in diagnosing the evolution of such a rare carcinoma.
収録刊行物
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- 日本臨床外科学会雑誌
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日本臨床外科学会雑誌 67 (12), 2923-2928, 2006
日本臨床外科学会
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詳細情報 詳細情報について
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- CRID
- 1390282679826219648
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- NII論文ID
- 130003604843
- 10018817905
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- NII書誌ID
- AA11189709
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- ISSN
- 18825133
- 13452843
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- 本文言語コード
- ja
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- データソース種別
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- JaLC
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- CiNii Articles
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- 抄録ライセンスフラグ
- 使用不可