内容紹介
Summary
We report synchronous resection of gallbladder hyperplasia polyps with pancreaticobiliary maljunction without dilation of the bile duct and sigmoid colon carcinoma. The patient was a 60-year-old woman diagnosed with sigmoid colon cancer. Gallbladder polyps were detected incidentally during a preoperative examination for sigmoid colon cancer that was discovered because of anemia. Detailed examination revealed a suspected gallbladder carcinoma along with pancreaticobiliary maljunction without dilation of the bile duct. The patient underwent synchronous open colectomy and cholecystectomy. Histopathological diagnosis excluded gallbladder carcinoma, so we did not perform bile duct resection or lymph node resection around the bile duct. The final diagnosis was gallbladder hyperplasia polyps, chronic cholecystitis, and sigmoid colon cancer(pT3N2M0, stage Ⅲb). Therefore, physicians should pay attention to the possibility of pancreaticobiliary maljunction if gallbladder polyps are detected incidentally during preoperative examination for other diseases. In the present case, we could treat the patient with minimally invasive techniques by adding the treatment to that performed for the other disease.
要旨
症例は60歳,女性。貧血を契機に発見されたS状結腸癌に対する術前検査で胆囊腫瘤を指摘された。精査の結果,胆管非拡張型膵・胆管合流異常を伴う胆囊癌疑いの診断で,S状結腸切除と同時に全層胆囊摘出術を施行した。術中迅速診断の結果,胆囊癌は否定された。永久標本の病理組織診断は,胆囊過形成ポリープ,慢性胆囊炎,S状結腸癌,pT3N2M0,stage Ⅲbであった。他疾患の術前検査などで胆囊内のポリープが偶然に指摘された場合,背景に膵・胆管合流異常が存在する可能性に留意すべきである。特に胆管非拡張例で胆囊病変が癌化する前であれば付加的に胆囊摘出術を行うことで必要最小限の侵襲で治療できる可能性がある。
目次
We report synchronous resection of gallbladder hyperplasia polyps with pancreaticobiliary maljunction without dilation of the bile duct and sigmoid colon carcinoma. The patient was a 60-year-old woman diagnosed with sigmoid colon cancer. Gallbladder polyps were detected incidentally during a preoperative examination for sigmoid colon cancer that was discovered because of anemia. Detailed examination revealed a suspected gallbladder carcinoma along with pancreaticobiliary maljunction without dilation of the bile duct. The patient underwent synchronous open colectomy and cholecystectomy. Histopathological diagnosis excluded gallbladder carcinoma, so we did not perform bile duct resection or lymph node resection around the bile duct. The final diagnosis was gallbladder hyperplasia polyps, chronic cholecystitis, and sigmoid colon cancer(pT3N2M0, stage Ⅲb). Therefore, physicians should pay attention to the possibility of pancreaticobiliary maljunction if gallbladder polyps are detected incidentally during preoperative examination for other diseases. In the present case, we could treat the patient with minimally invasive techniques by adding the treatment to that performed for the other disease.
要旨
症例は60歳,女性。貧血を契機に発見されたS状結腸癌に対する術前検査で胆囊腫瘤を指摘された。精査の結果,胆管非拡張型膵・胆管合流異常を伴う胆囊癌疑いの診断で,S状結腸切除と同時に全層胆囊摘出術を施行した。術中迅速診断の結果,胆囊癌は否定された。永久標本の病理組織診断は,胆囊過形成ポリープ,慢性胆囊炎,S状結腸癌,pT3N2M0,stage Ⅲbであった。他疾患の術前検査などで胆囊内のポリープが偶然に指摘された場合,背景に膵・胆管合流異常が存在する可能性に留意すべきである。特に胆管非拡張例で胆囊病変が癌化する前であれば付加的に胆囊摘出術を行うことで必要最小限の侵襲で治療できる可能性がある。