A Case of Annular Pancreas with Cholelithiasis and Gallbladder Carcinoma

Yoshiki Okamoto, Shyunjyu Indo, Hisao Wakabayashi*, Yasuyuki Suzuki* and Takashi Maeba

Department of Surgery, Social Insurance Ritsurin Hospital
Department of Gastroenterological Surgery, Kagawa University*

An 81-year-old woman reporting epigastralgia, nausea and vomiting and found to have a gall bladder abnormality underwent abdominal echography, CT, MRCP, ERCP, gastroduodenal contrastoimaging and upper digestive endoscopy, which revealed gallstones and annular pancreas necessitating surgery. We planned cholecystectomy and choledocholithotomy. The head of pancreas rounded around 2/3 from anterior surface of the duodenum to right lateral. We found an 18×15×2 mm elevating lesion in the resected gallbladder. We sampled a 12c lymph node swelled firmly. The histopathological findings of these were adenocarcinoma. Based on a diagnosis of gallbladder cancer, we dissected D2 lymph nodes. The woman's postoperative course was uneventful and she was discharged on postoperative 40 day. She has shown no disease recurrence as of this writing in the 4 years and 6 months since surgery.

Key words
annular pancreas, cholelithiasis, gallbladder carcinoma

Reprint requests
Yoshiki Okamoto Department of Gastroenterological Surgery, Faculty of Medicine, Kagawa University
1750-1 Miki-cho, Kita-gun, Ikenobe, 761-0793 JAPAN

Accepted
March 25, 2009

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