Gallbladder Cancer Accompanied by Anomalous Pancreatico-Biliary Ductal System: A thorough study of a case by means of clinical and pathophysiological findings Koki Tanaka 1 , Akira Ikoma 1 , Akira Taira 1 , Hiroto Sakamoto 2 , Yukinori Sameshima 3 1The Second Department of Surgery, Faculty of Medicine, Kagoshima University 2The Second Department of Internal Medicine, Faculty of Medicine, Kagoshima University 3The Second Department of Pathology, Faculty of Medicine, Kagoshima University pp.1031-1036
Published Date 1986/9/25
DOI https://doi.org/10.11477/mf.1403110243
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 A case of gallbladder cancer, a 55 year-old woman accompanied by anomalous pancreatico-biliary ductal system has been reported. Cholecystectomy, hepatectomy and pancreatico-duodenectomy were perfomed on this patient. The histopathological criteria of anomalous pancreatico-biliary ductal system were verified in the excised specimen. Preoperative analysis of imaging techniques were in accord with the findings concerning the specimen. On ERCP an anomalous junction was located at 3 cm from the ampulla of Vater and the length of the, narrow distal segment was 1. 5 cm (Fig. la). On the specimen the cross section of every 5 mm in width from the ampulla of Vater to the junction revealed a common channel surrounded by the sphincter of Oddi and muscularis propria of the duodenum (Fig. 8 slice A). At 15 mm from the ampulla of Vater the sphincter of Oddi had partially disappeared and the muscularis propria was not completely recognizable. The length of narrow distal segment was about 15 mm. At the junction, both the common bile duct and the main pancreatic duct were excluded from the sphincter muscle. It should be stressed that a thorough study in clinical imaging technique and histopathological examination after the operation are both important for a balanced judgment in the treatment of cases with anomalous pancreaticobiliary ductal system.

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