Abstract
The case is a woman of 57-year-old, and underwent the laparoscopic cholecystectomy with the diagnosis of the chronic cholecystitis 15 months ago. Though abdominal ultrasonography undergone at that-time showed slight wall thickning and swelling of the gallbladder, cholecystolithiasis could not be recognized. And in DIC, the gallbladder was not depicted.
This time she had an obstructive jaundice and PTCD was performed. Cholangiogram via PTCD showed the complete obstruction of the common hepatic duct, and it was diagnosed as a bile duct cancer. In the operative findings, the remnant cystic duct of the gallbladder adhered to the bulbus of the duodenum, and since there is an adenocarcinoma in the peeled lesion, the pancreatoduodenectomy was performed. It was pathohistologically primary well differentiated adenocarcinoma of the cystic duct of the gallbladder.
In the case that the gallbladder is not depicted with direct cholangiogram and that there is swelling of the gallbladder, it always wakes up in the mind in respect of the coexistence of the cancer of the cystic duct of the gallbladder, and the indication of the laparoscopic cholecystectomy should be prudently decided.
