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Japanese

Gallbladder Carcinoma with Direct Hepatic Invasion, Report of Two Cases Atsutake Okamoto 1 , Koji Tsuruta 1 , Tomoaki Isawa 2 , Ikuo Tabata 2 , Jyunichi Ishiwata 2 , Atsushi Tanaka 3 , Morio Koike 3 1Department of Surgery, Tokyo Metropolitan Komagome Hospital 2Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital 3Department of Pathology, Tokyo Metropolitan Komagome Hospital pp.601-605
Published Date 1987/5/25
DOI https://doi.org/10.11477/mf.1403112869
  • Abstract
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 〔Case 1〕 A 67 year-old woman was admitted with the complaint of epigastric pain and palpable right upper quadrant mass. Ultrasonography showed thickened gallbladder wall and a large mass with irregular echoes in the liver. Computed tomography (CT) revealed a large low density area which was enhanced after contrast infusion. Celiac arteriography revealed luminal irregularity and stretching of the cystic branches. Cholecystectomy with partial hepatic resection and node dissection were performed. Four years and two months after surgery, she is still free from the disease.

 〔Case 2〕 A 72 year-old man was admitted on account of painless jaundice. Percutaneous transhepatic cholangiogram (PTC) showed dilated intrahepatic bile ducts with marked stenosis at the hepatic hilus. For technical reasons, the gallbladder was difficult to visualize by ultrasonography. CT showed a slight thickened wall of the gallbladder and multiple low density areas in the liver. The cystic artery was not delineated and encasement of the hepatic branches was noted by selective hepatic arteriography. These findings in CT and arteriography suggested cholangiocarcinoma of the liver or gallbladder carcinoma with direct hepatic invasion. At laparotomy, examination of frozen section of the tumor showed gallbladder carcinoma with hepatic invasion. Right trisegmentectomy of the liver with resection of the extrahepatic duct was performed. One year and six months after successful surgery, the patient is doing well.


Copyright © 1987, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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