Early carcinoma of common bile duct; Report of a resected case

Abstract

Surgical resected case of early carcinoma of common bile duct was described. A 67-year-old female was admitted to our hospital with unexplained abnormal liver function tests and dilatation of biliary duct on abdominal ultrasonogram. Abdominal CT documented tumor in the lower common bile duct, and endoscopic retrograde cholangiogram was highly suggestive of malignant stricture. Several biopsy specimens were obtained from the tumor and also normally appeared mucosa using cholangioscopy inserted through the PTC route. They were reported as showing adenocarcinoma with intraepithelial spread. The depth of invasion was considered as“fm”by the estimation using EUS and IDUS.
Pancreatoduodenectomy was performed and secondary deposite was not seen in the lymph nodes during surgery. Pathological examination of resected specimen was reported as early carcinoma of the lower common bile duct with the depth of invasion confined to“fm”. Histologically, carcinoma was well-differentiated papillo-tubular type with intraepithelial spead up to the upper bile duct.
Cholangioscopy and biopsy inserted through the PTC route played an important role in determining the surgical resectionline in this case.