Korean Journal of Gastrointestinal Endoscopy 2005;30(6): 340-344.
수술 전 진단된 무증상 결절형 조기 간외 담관암
조경란·최호순·양선영·윤재훈·이항락·이오영·윤병철·함준수·이민호·이동후·기춘석
한양대학교 의과대학 내과학교실
Preoperatively Diagnosed Asymptomatic Early Extrahepatic Bile Duct Cancer
Kyung Ran Cho, M.D., Ho Soon Choi, M.D., Sun Young Yang, M.D., Jai Hoon Yoon, M.D., Hang Lak Lee, M.D., Oh Young Lee, M.D., Byung Chul Yoon, M.D., Jun Soo Hahm, M.D., Min Ho Lee, M.D., Dong Hoo Lee, M.D. and Chun Suk Kee, M.D.
Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea
Abstract
Cholangiocarcinoma is usually diagnosed at the advanced stage because early symptoms and signs are relatively infrequent. The preoperative diagnosis of early extrahepatic bile duct cancer in common bile duct is uncommon. Also, an extrahepatic bile duct cancer arising from the lower portion of the common bile duct is usually papillary and rarely nodular or sclerosing. We decribe a case, preoperatively diagnosed as early extrahepatic bile duct cancer in lower portion of common bile duct, nodular type on endoscopic retrograde cholangiography. It was incidentally detected by the slight elevation ofγ-glutamyl transpeptidase without any symptoms. An endoscopic retrograde cholangiography showed abrupt narrowing of the intrapancreatic portion of the common bile duct with irregular and nodular filling defect. The lesion was confined to mucosa on the endoscopic ultrasonography. This patient was diagnosed as early extrahepatic bile duct cancer and underwent Whipple's operation. A histopathologic examination of resected specimen revealed to be moderately differentiated adenocarcinoma at stage 1 (T1N0Mo) in the extrahepatic bile duct. (Korean J Gastrointest Endosc 2005;30:340344)
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