Three cases of biliary tract malignant tumors discovered after cholecystectomy for acalculous cholecystitis

Abstract

Case 1: A 76-year-old man developed obstructive jaundice 8 months after laparoscopic cholecystectomy for acalculous cholecystitis. Further examination led to a diagnosis of distal cholangiocarcinoma. Pancreaticoduodenectomy was performed, and a pathological examination confirmed gallbladder duct carcinoma extending into the distal bile duct. Case2: An 80-year-old man underwent laparoscopic cholecystectomy for acalculous cholecystitis. A tumorous lesion was identified in the gallbladder neck from the resected specimen of the gallbladder duct. A pathological examination confirmed gallbladder duct carcinoma, and infiltration to the gallbladder duct stump was noted. Therefore, additional resection of the gallbladder duct and regional lymph node dissection were performed. Case3: An 82-year-old man developed hyperamylasemia approximately 4 months after laparoscopic cholecystectomy for acalculous cholecystitis. Further examination led to a diagnosis of Bismuth type I hilar cholangiocarcinoma. Extrahepatic choledochotomy with regional lymph node dissection was performed. A pathological examination confirmed hilar cholangiocarcinoma infiltrating the gallbladder duct. In cases of acalculous cholecystitis, preoperative evaluation and treatment should be conducted with the possibility of concomitant malignant tumors in mind. For cases where the cause remains undetermined, careful postoperative follow-up is necessary.