原発性胆嚢管癌の1例

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  • A CASE OF PRIMARY CARCINOMA OF THE CYSTIC DUCT

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We have recently experienced a case of primary carcinoma of the cystic duct. A 77-year-old man was seen at the hospital because of jaundice. Ultrasonography and abdominal CT scan showed a tumor in the vicinity of the cystic duct. Percutaneous transhepatic cholangiography showed a smooth obstruction in the middle of the comon bile duct, and cholangio-fiberscope demonstrated an irregular red colored lesion in it. Cholecystectomy together with resection of the bile duct was performed with cleaning of the regional lymph nodes under a preoperative diagnosis of cystic duct carcinoma. A 2.0×1.0cm tumor was found at the cystic duct. Histological examination revealed well differentiated adenocarcinoma infiltrating into the serosa with metastasis to one of the regional lymph nodes. Invasion to the bile duct as well as neck of the gallbladder was also identified. The patient died of metastasis to the liver 26 months afte the operation.<br> Thirty eight cases of primary carcinoma of the cystic duct in the Japanese literature, including the present case, are also reviewed. Advanced carcinoma of the cystic duct often causes obstructive jaundice, similar to bile duct carcinomas, due to invasion to the extrahepatic bile duct. It is necessary to choose appropriate procedures according to the stage of cancer spread.

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