A CASE OF MUCOSAL CARCINOMA OF THE GALLBLADDER ASSOCIATED WITH CONGENITAL DILATATION OF THE BILE DUCT DIAGNOSED BY PERCUTANEOUS TRANSHEPATIC CHOLECYSTOSCOPY (PTCCS)

Abstract

A 42-year-old man was admitted to the hospital complaining of abdominal pain and diarrhea. Ultrasonography and CT revealed a tumor in the gallbladder and dilatation of the bile duct, which was diagnosed as congenital dilatation of the bile duct complicated with gallbladder carcinoma by ERCP. Ultrasonically guided transhepatic drainage of the gallbladder was carried out, and PTCCS was performed after dilating the sinus tract of the catheter. A soft and papillary tumor was observed, and diagnosed as adenocarcinoma by cholecystoscopic biopsy. Cholecystectomy with resection of the liver bed and the dilated bile duct was perfor-med. A papillary tumor, 32 X 25 mm in size, was found in the fundus. Microscopical diagnosis was well-differenciated adenocarcinoma infiltrating in the mucosa. It is safe and easy to observe the lesion and take a biopsy specimen by PTCCS. PTCCS is useful to make a definite diagnosis of a small lesion of the gallbladder.