Abstract
An 81-year-old man consulted our hospital with upper abdominal pain and abnormality of liver function. He has a previous history of laparoscopic cholecystectomy due to gall stones twenty years ago. A 20-mm solid tumor was detected adjacent to the clip of the cystic duct stump on abdominal CT. ERC and MRCP showed right-sided smooth stricture of the middle bile duct caused by compression from tumor. EUS and intraductal ultrasonography (IDUS) demonstrated a low echoic mass in the remnant cystic duct and showed normal finding of biliary mucosa, so we predicted submucosal tumor like amputation neuroma or cystic duct carcinoma. Tissue biopsy was useful in confirming the diagnosis of cystic duct carcinoma. We performed extrahepatic bile duct resection with D2 lymph node dissection. Pathological examination indicated primary tumor of remnant cystic duct and lymph node metastasis. This patient is doing well 5 months after surgery without recurrence. We report a rare case of primary cancer of remnant cystic duct after laparoscopic cholecystectomy.
