A Case of Gallbladder Carcinoma Growing into the Common Hepatic Duct Through the Cholecysto-hepatidochal Fistula

Kenji Kobayashi, Takashi Hirai, Hiroshi Maeno, Hiroshi Kojima, Junichi Sakamoto, Kenzo Yasui, Yoshitaka Yamamura, Tomoyuki Kato, Mitsunori Yasue, Tsuyoshi Kito, Seiichi Miyaishi, Hiroaki Nakazato

Department of Gastroenterological Surgery, Aichi Cancer Center Hospital

A 66 year-old man was admitted complaining of abdominal pain and fever. According to the examinations (ultrasonography, CT scan, percutaneous transhepatic cholangiography, percutaneous transhepatic cholagioscopic biopsy), firstly gallbladder carcinoma invading the common hepatic duct with cholecysto-hepatidochal fistula, and secondary bile duct carcinoma invading the gallbladder were suspected. Cholecystectomy, choledochectomy and hepaticoduodenostomy were performed. Mixed type stones were found in the common bile duct, the common hepatic duct and the gallbladder. A large fistula between the gallbladder and the common hepatic duct was noted, and a large pedunculated polypoid tumor originated from the neck of the gallbladder grew into the common hepatic duct through the cholecysto-hepatidochal fistula, which seemed to be formed secondary to cholecystolithiasis. Pathological diagnosis was papillary adenocarcinoma. The regional lymph nodes were not involved. At 1 year after surgery the patient had no signs of recurrence.

Key words
gallbladder carcinoma, cholecysto-hepatidochal fistula

Reprint requests
Kenji Kobayashi Department of Gastroenterological Surgery, Aichi Cancer Center Hospital
1-1 Kanokoden, Thikusa-ku, Nagoya, 464 JAPAN

Accepted
July 10, 1990

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