1990 Volume 23 Issue 3 Pages 791-795
We recently encountered a case of gallbladder carcinoma with a cholecystoduodenal fistula and a cholecystocolic fistula. A 68-year-old woman was admitted to our hospital with the chief complaint of right hypochondralgia and fever. Abdominal ultrasonography and abdominal CT scan showed a mass, 7× 8 cm, in size, at the right hypochondral lesion, and hypotonic duodenography revealed internal fistulas between the gallbladder and duodenum and between the gallbladder and colon. Resection of segments 4a, 5 and 6 of the liver, and pancreaticoduodenectomy with right hemicolectomy were performed, and examination of the excised specimen revealed a cholecystoduodenal fistula and a cholecystocolic fistula. Histologic diagnosis was adenosquamous cell carcinoma. The prognosis of advanced gallbladder carcinoma is very poor, but in this case lymphnode metastasis is negative and good prognosis can be expected, so we think the treatment of advanced cases such as this one should be extended surgery.
