肝管走行異常に発生した胆管癌の1例

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  • A CASE REPORT OF CANCER OF THE BILE DUCT WITH AN ACCESORY BILE DUCT

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A rare case pf cancer of the bile duct with an accessory bile duct was experienced. The patient was a 68-year-old woman. She was admitted to the hospital because of right hypochondralgia, back pain, swallen gallbladder, and increases in biliary enzymes, on September 9, 1993. On an abdominal ultrasono-graphy, computed tomography, endoscopic retrograde cholangiography (ERCP) and percutaneus transhe-patic cholangiography (PTC), cancerous stenosis of the common bile duct with an accessory bile duct was observed. Resection of the gallbladder and choledochus with regional lymphadenectomy (R2) was perfor-med. Histological diagnosis was well differentiated adenocarcinoma with wall invasion of of and nl(+) in stage III. The patient fares well without evidence of recurrence as of one year the surgery.<br> In many cases the accessory bile duct is first diagnosed during operation. When we encounter a case scheduled for an operation for a biliary lesion, especially a cancer of the bile duct is suspected, it is very important to gain the detail information of the bile duct by ERCP or PTC before operation and to perform intraoperative cholangiography.

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