Ushida Yuta, Hiramatsu Kiyoshi, Saeki Satomi, Amemiya Takeshi, Goto Hidenari, Arai Toshiyuki
Department of Surgery, Anjo Kosei Hospital, 28 Higashihirokute, Anjo-cho, Anjo, Aichi, 446-8602, Japan.
Surg Case Rep. 2017 Dec;3(1):14. doi: 10.1186/s40792-017-0287-1. Epub 2017 Jan 17.
An 82-year-old woman with common bile duct (CBD) dilatation observed during routine ultrasonography was referred to our hospital. Preliminary blood tests revealed elevated levels of hepatobiliary enzymes. Computed tomography (CT) scan showed lower bile duct wall thickening and enhancement. Esophagogastroduodenoscopy revealed mildly swollen papilla of Vater, without ulceration. Endoscopic retrograde cholangiography demonstrated that the CBD was grossly dilated with a constriction in the lower part. The final diagnosis indicated poorly differentiated adenocarcinoma of duodenal papilla with signet-ring cells; pT3N0M0, stage IIA (Unio Internationalis Contra Cancrum, 7th edition), for which subtotal stomach-preserving pancreaticoduodenectomy (SSPPD) was performed. This case is quite rare, and the surgery resulted in a desirable outcome. The patient has been disease-free for 5 years since the surgery.
一名82岁女性在常规超声检查时发现胆总管（CBD）扩张，遂转诊至我院。初步血液检查显示肝胆酶水平升高。计算机断层扫描（CT）显示低位胆管壁增厚并强化。食管胃十二指肠镜检查显示 Vater 乳头轻度肿胀，无溃疡。内镜逆行胰胆管造影显示胆总管明显扩张，下段有狭窄。最终诊断为十二指肠乳头低分化腺癌伴印戒细胞；pT3N0M0，IIA期（国际抗癌联盟第7版），为此进行了保留胃的胰十二指肠次全切除术（SSPPD）。该病例非常罕见，手术取得了理想的效果。自手术以来，患者已无病生存5年。
