A Case of Gallbladder Cancer Resulting in Biliary Hemorrhage and Obstruction with Pancreaticobiliary Maljunction

Abstract

A 70-year-old woman was admitted owing to right hypochondralgia. Blood biochemistry studies, abdominal ultrasonography, and abdominal CT suggested biliary obstruction caused by a biliary stone. Emergency endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy were performed. Clotted blood was found in the bile duct. Cholangiopancreatography revealed pancreaticobiliary maljunction and a filling defect, suggesting a tumor in the gallbladder. We performed resection of the gallbladder and its bed, and dissection of the lymph node. The preoperative diagnosis was gallbladder cancer with a hemorrhage that caused biliary obstruction. The histological diagnosis was papillary adenocarcinoma. The patient died 4 years later because of multiple metastases in the lung, brain, and lymph nodes. We describe a rare case of gallbladder cancer causing biliary hemorrhage and obstruction with pancreaticobiliary maljunction.