Gallbladder carcinoma with choledochoduodenal fistula: a case report with surgical treatment.
A 79 year-old man was admitted to our hospital because of upper abdominal pain and nausea. A mobile tumor was palpable in the right upper abdomen. Abdominal ultrasonography, computed tomography and celiac angiography revealed a gallbladder tumor. Endoscopic retrograde cholangiopancreatography revealed a fistula 1.5 cm oral to the orifice of the papilla of Vater, dilatation of the common bile duct, and a filling defect in the gallbladder. Pancreatoduodenectomy associated with reconstruction using Imanaga's method was performed under a pre-operative diagnosis of gallbladder carcinoma with choledochoduodenal fistula. The gallbladder contained a tumor and two bilirubin stones impacted in the orifice of the duodenal papilla. Histological studies confirmed that the gallbladder tumor was a mucinous adenocarcinoma and had not infiltrated the bile duct. We speculated that choledochoduodenal fistula stimulated the development of cancer due to chronic irritation from pancreatic juice reflux.
Okabe
T
T
Second Department of Surgery, Gunma University School of Medicine, Maebashi, Japan.
Ohwada
S
S
Ogawa
T
T
Takeyoshi
I
I
Sato
Y
Y
Kamoshita
N
N
Kon
Y
Y
Fukusato
T
T
Ohhara
K
K
Morishita
Y
Y
D000368:Aged; D001658:Biliary Fistula / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003137:Common Bile Duct Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D003952:Diagnostic Imaging; D004378:Duodenal Diseases / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D005704:Gallbladder / Q000473:pathology; D005706:Gallbladder Neoplasms / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007412:Intestinal Fistula / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D008297:Male; D016577:Pancreaticoduodenectomy