Abstract
A 80-year-old woman was admitted to our hospital with the chief complaint of abdominal pain and fever. She has a past history of cholecystolithiasis and hyperlipemia Inflammation due to cholecystitis was decreased after admission by administration of antibiotics and a fast. Ultrasonography revealed wall thickening of gallbladder and gallstones. Magnetic resonance chongiopancreatography (MRCP) and drip infusion cholangiographycomputed tomography (DIC-CT) revealed inferior part of bile duct. Endoscopic retrograde cholangiography (ERCP) revealed irregular narrowing of inferior part of bile duct and intraductal ultrasonography showed circular thickening of inferior part of bile duct. Biopsy from stenotic lesion using forceps for endoscopic circular biopsy showed papillary adenocarcinoma. Subtotal stomach preserving pancreatoduodenectomy was performed with the diagnosis of carcinoma of inferior part of bile duct. Resected specimen showed papillary tumor in the inferior part of bile duct 20×12 mm in size. Pathological diagnosis was papillary adenocarcinoma with invasion deapth of mucosa. The patient is alive without recurrence for 24 months. Early diagnosis could be done for biliary tract disease with using modality such as DIC-CT and forceps for endoscopic circular biopsy.
