Early upper bile duct cancer diagnosed one year after endoscopic lithotripsy of common bile duct stones: A case report

Abstract

A 70-year-old man was hospitalized for right upper abdominal pain. Abdominal CT, MRCP, and ERCP revealed irregular-shaped stones in the common bile duct with no stones in the gallbladder. The stones were removed following endoscopic sphincterotomy. One year after the endoscopic treatment, he was re-hospitalized for right upper abdominal pain. Abdominal CT showed slight contrast enhancement suggesting bile duct cancer. ERCP revealed a papillary lesion in the upper bile duct, and a biopsy diagnosis of well-differentiated adenocarcinoma was obtained. He underwent extrahepatic bile duct resection, with the final pathological diagnosis of stage 1A cholangiocarcinoma. As bile duct cancer can be complicated by bile duct stones, further examination is needed after endoscopic lithotripsy, especially when irregular-shaped bile duct stones are present.