Abstract
The patient was a 76-year-old man with distal BTC. Multiple liver metastases were detected during laparotomy. We judged the tumor to be unresectable and inserted a biliary tract metallic stent. We initiated chemotherapy with GEM+CDDP. After five courses of chemotherapy, no liver metastases were visualized on computed tomography. However, a swollen lymph node (#13) with abnormal uptake was observed. Thirty-three months after laparotomy, pancreatoduodenectomy was performed on this patient, whereupon pathological investigations confirmed a T2N0M0, Stage IB. Intraoperative findings revealed no remaining liver metastasis. Ten months after "conversion surgery," the patient was alive and well, with no signs of recurrence. The efficacy of conversion surgery for unresectable BTC has not been determined. However, it is important to evaluate the feasibility of conversion surgery for patients with unresectable BTC. Further studies are required to establish a treatment strategy for unresectable BTC that includes conversion surgery.
