Abstract
A 55-year-old man who was diagnosed with locally advanced unresectable carcinoma of the cystic duct with lymph nodes metastasis was referred to our hospital after incomplete laparotomy at a previous hospital. In our hospital, the combination chemotherapy with gemcitabine and cisplatin (GC) was performed, and the primary tumor and the lymph nodes metastasis were remarkably reduced in size. Pancreatoduodenectomy with lymph nodes dissection was performed as a curative resection. The pathological diagnosis was moderately differentiated tubular adenocarcinoma extremely localized in the cystic duct with no lymph node metastasis. He was discharged from our hospital without major postoperative complications, and has been alive as of one and half years after the surgical resection without having recurrence.
While surgical resection is the only curative treatment for biliary cancer, most of the cases are diagnosed as unresectable when they are detected. Downsizing chemotherapy with GC provides improvement of the ratio of curative resection and longer survival, and has a potential for the promising treatment strategies for the patients with initially unresectable locally advanced biliary cancer.
