Gallbladder Carcinoma with Cholecystoduodenal Fistula and Cholecystocolic Fistula -Report of a Case-

Yoshimi Kitagawa, Masatoshi Akita, Hiroshi Hasegawa, Akihiko Ohta, Hideto Yoshida, Hiroshi Kawabe, Masato Nagino*

Department of Surgery, Nagoya Second Red Cross Hospital
*First Department of Surgery, Nagoya University School of Medicine

We recently encountered a case of gallbladder carcinoma with a cholecystoduodenal fistula and a cholecystocolic fistula. A 68-year-old woman was admitted to our hospital with the chief complaint of right hypochondralgia and fever. Abdominal ultrasonography and abdominal CT scan showed a mass, 7×8 cm, in size, at the right hypochondral lesion, and hypotonic duodenography revealed internal fistulas between the gallbladder and duodenum and between the gallbladder and colon. Resection of segments 4a, 5 and 6 of the liver, and pancreaticoduodenectomy with right hemicolectomy were performed, and examination of the excised specimen revealed a cholecystoduodenal fistula and a cholecystocolic fistula. Histologic diagnosis was adenosquamous cell carcinoma. The prognosis of advanced gallbladder carcinoma is very poor, but in this case lymphnode metastasis is negative and good prognosis can be expected, so we think the treatment of advanced cases such as this one should be extended surgery.

Key words
cholecystoduodenal fistula, cholecystocolic fistula, gallbladder cancer

Reprint requests
Yoshimi Kitagawa Department of Surgery, Nagoya Second Red Cross Hospital
2-9 Myouken-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
November 8, 1989

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