Obayashi Miku, Maruo Hirotoshi, Koakutsu Toru, Hayashi Yoshiro, Shibasaki Yasushi, Shoji Tsuyoshi, Hirayama Kazuhisa, Yamazaki Masanori
Dept. of Surgery, Shizuoka City Shimizu Hospital.
Gan To Kagaku Ryoho. 2020 Dec;47(13):2290-2292.
A 75-year-old man with a chief complaint of abdominal pain visited our hospital and was diagnosed with Stage Ⅳ gallbladder carcinoma that infiltrated the transverse colon with distant lymph node metastases. He received gemcitabine plus cisplatin chemotherapy, which led the primary lesion to shrink. However, transverse colon obstruction occurred, and semi- urgent right hemicolectomy and extended cholecystectomy were performed. A year and 2 months after first diagnosis, an inferior pancreatic head lymph node swelling was detected. Chemoradiotherapy was performed using S-1, and the lymph node swelling was reduced. Despite continuous S-1 therapy, the lymph node gradually started to swell again, which led to duodenum obstruction by compression. He underwent gastrojejunal bypass; however, his general condition gradually worsened, and he died 2 years and 6 months after the first diagnosis. Even in cases of unresectable gallbladder carcinoma, multimodal therapy, such as surgery, chemoradiotherapy, and palliative gastrointestinal bypass, may archive a long prognosis of 2 years and 6 months.
一名以腹痛为主诉的75岁男性患者前来我院就诊，被诊断为Ⅳ期胆囊癌，肿瘤侵犯横结肠并伴有远处淋巴结转移。他接受了吉西他滨联合顺铂化疗，这使得原发灶缩小。然而，出现了横结肠梗阻，遂进行了半急诊右半结肠切除术及扩大胆囊切除术。首次诊断后1年零2个月，发现胰头下淋巴结肿大。采用S-1进行放化疗，淋巴结肿大有所减轻。尽管持续进行S-1治疗，但淋巴结又逐渐开始肿大，导致十二指肠受压梗阻。他接受了胃空肠吻合术；然而，他的一般状况逐渐恶化，在首次诊断后2年零6个月死亡。即使是不可切除的胆囊癌病例，手术、放化疗及姑息性胃肠吻合术等多模式治疗也可能使患者获得长达2年零6个月的生存期。
