Abstract
Recent progression in medical thechnology has enabled us to diagnose some gallbladder carcinomas in a relatively early stage. It is the present condition, however, that almost gallbladder carcinomas are still detected in an advanced stage. This paper describes a case of gallbladder carcinoma associating with cholecystocolonic fistula.
A 79-year-old woman was admitted to the hispital because of an abdominal mass. Based on examinations with ultrasonography. CT, barium enema, and ERCP, the patient was diagnosed as having a gallbladder carcinoma, cholecystocolonic fistula, and choledocholith, and was operated on. It was found that the gallbladder was separated from the liver; most of the organ was filled with carcinoma cells, infiltrating into the transverse colon; a cholecystocolonic fistula 7 mm in diameter existed at the cervical region; and 3 calcium bilirubinate stones presented in the common bile duct. Cholecystectomy, incision of the common bile duct, insertion of T-tube, and partial excision of the transverse colon were carried out. Histologically it was a moderately differentiated papillary carcinoma, 7×4×2 cm in size, infiltrating into muscular layer of the transverse colon. The fistula was mostly comprized of inflammatory changes, which might be an internal biliary fistula due to cholecystitis associated with the carcinoma. There has been no signs of recurrence, as of one year after surgery, and the patient is followed on an ambulant basis.
This paper also presents some notes on accumulated 20 cases from the Japanese literature.
