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Two patients with carcinoma of the cystic duct presented with obstructive jaundice due to extrinsic compression of the common hepatic duct by the tumor. Sonography and computed tomography showed dilatation of the intrahepatic bile ducts and gallbladder. In one patient, a calculus seen in the gallbladder neck suggested Mirizzi syndrome. In the other, a small soft tissue mass was indistinguishable from a common duct tumor or an enlarged lymph node. In both cases, direct cholangiography demonstrated extrinsic compression and displacement of the common duct with proximal biliary dilatation and nonvisualization of the gallbladder. Carcinoma of the cystic duct should be considered whenever there is evidence of cystic duct obstruction and/or when cholangiography shows extrinsic mass effect on the common duct. 相似文献
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Sato M Watanabe Y Kikkawa H Kohtani T Suzuki H Nezu K Yoshida M Kawachi K Nakagawa Y 《Journal of gastroenterology》2001,36(4):276-280
Received: February 4, 2000 / Accepted: May 26, 2000 相似文献
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Carcinoma of the cystic duct associated with opisthorchiasis. 总被引:1,自引:0,他引:1
T Chainuvati A Paosawadhi M Sripranoth S Manasatith V Viranuvatti 《The Southeast Asian journal of tropical medicine and public health》1976,7(3):482-486
Four patients who had obstructing carcinoma of the cystic duct and who presented themselves with enlarged and palpable gall bladders but without jaundice are reported. All patients came from endemic areas of opisthorchiasis and had evidence of Opisthorchis infection by peritoneoscopic and surgical findings. All but one had Opisthorchis eggs in the stool. The pathogenesis and management was discussed. 相似文献
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Postcholecystectomy pain may remain unexplained and difficult to treat. This report describes three patients with constant postcholecystectomy abdominal pain that may have arisen from the cystic duct remnant or a neuroma of the cystic duct stump. In each case pain was exacerbated by pushing on cystic duct surgical clips with an EUS-guided needle, and temporarily abolished by an EUS-guided injection of bupivicaine and triamcinolone. Two patients underwent surgical resection of the cystic duct remnant and the third did not require further treatment. Two of the three patients had long-term improvement. EUS is a novel modality for assessing the cystic duct remnant and performing a therapeutic trial. 相似文献
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Kimihito Fujii Masato Nagino Junichi Kamiya Katsuhiko Uesaka Tsuyoshi Sano Norihiro Yuasa Koji Oda Yuji Nimura 《Journal of hepato-biliary-pancreatic sciences》2004,11(6):441-444
A 61-year-old man presented with anemia (hemoglobin, 5.9?mg/dl) and a history of alcoholic liver disease. The patient also had a past history of a distal gastrectomy and Billroth II reconstruction, due to a gastric ulcer, performed 20 years previously. Endoscopic gastroscopy revealed a hemorrhagic ulcerative tumor at the gastrojejunostomy site. Computed tomography and angiography demonstrated a 10-cm tumor and a 2-cm tumor in the left lateral segment of the liver, suggestive of hepatocellular carcinoma (HCC). The larger tumor showed extrahepatic growth, with invasion of the stomach remnant. Because transcatheter arterial embolization of the tumor failed to control the bleeding, we carried out an en-bloc resection of the left lateral segment of the liver and the stomach remnant. Direct invasion of HCC into the gastrointestinal tract is rarely encountered. Here we report a case of HCC that invaded the stomach remnant and present a review of the literature. 相似文献
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Mukhlesur Rahman Bhuiya Yuji Nimura Junichi Kamiya Satoshi Kondo Masato Nagino Michio Kanai Katsuhiko Uesaka Naokazu Hayakawa 《Journal of hepato-biliary-pancreatic sciences》1997,4(2):223-226
A case of recurrent carcinoma of the cystic duct remnant invading the common bile duct and portal vein with subcutaneous implantation of the abdominal wall is presented. The patient was a 55-year-old woman with an abdominal wall tumor at the site of the surgical scar of a cholecystectomy, performed at a local hospital 5 years ago for symptomatic cholelithiasis. The diagnosis was made by incisional biopsy of the tumor, computed tomography, percutaneous transhepatic cholangiography, and angiography. She underwent extended right hepatic lobectomy with en bloc resection of the caudate lobe, extrahepatic bile duct, and portal vein. The abdominal wall tumor was resected concomitantly. Histological examination showed that both the recurrent carcinoma of the cystic duct remnant and the abdominal wall implantation were moderately differentiated adenocarcinoma. This recurrence probably could have been prevented if both the macroscopic and microscopic examinations of the resected specimen had been precisely carried out after the previous cholecystectomy and the primary carcinoma identified and treated at that time. 相似文献
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Dr. Boudewijn de Waele MD Jean Beaurang MD Leo Smekens MD Mia Pipeleers-Marichal MD 《Digestive diseases and sciences》1984,29(9):865-867
Summary Twenty-one cases of primary carcinoma of the cystic duct have been reported in the literature. Most cases were characterized by a hydrops or cholecystitis, whereas only two patients presented with jaundice. To our knowledge, this is only the third case of obstructive jaundice caused by a primary cystic duct carcinoma. The patient was treated by cholecystectomy with resection of the cystic duct tumor and a portion of the common bile duct. Reconstruction was performed by a Roux-en-Y choledocojejunostomy. 相似文献
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Tsuyoshi Itoh Nobuaki Fuji Hiroki Taniguchi Satoru Yasukawa Hiroaki Yasuda Naoki Wakabayashi Taiji Watanabe Toshiyuki Kosuga Kingo Kashimoto Akio Yanagisawa Kazuyo Naito 《Journal of hepato-biliary-pancreatic sciences》2008,15(3):338-343
We report a case of double cancer of the cystic duct and gallbladder associated with low junction of the cystic duct. A 73-year-old woman was admitted to the hospital complaining of upper abdominal pain. Endoscopic retrograde cholangiography showed a stenotic lesion in the lower common bile duct and no visualization of the cystic duct or gallbladder. Enhanced computed tomography revealed a heterogeneously enhanced tumorous lesion around the lower bile duct in the pancreatic head. A diagnosis of cancer arising from the cystic duct that entered the lower part of the common hepatic duct was made by intraductal ultrasonography, which showed an intraluminal protruding lesion in the cystic duct. Isolated gallbladder cancer was also diagnosed, by abdominal computed tomography. She underwent pancreaticoduodenectomy with dissection of regional lymph nodes. Histological examination revealed moderately differentiated adenocarcinoma of the cystic duct and well-differentiated adenocarcinoma of the gallbladder. Double cancer of the cystic duct and gallbladder is extremely rare, and this case also suggests a relationship between a low junction of the cystic duct and neoplasm in the biliary tract. 相似文献
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Post-cholecystectomy syndrome refers to a wide spectrum of conditions that pose a challenging diagnostic dilemma. Cystic duct remnant, defined as a residual duct greater than 1 cm in length, may, in the presence of stones, cause post-cholecystectomy syndrome. In this report, 4 patients with post-cholecystectomy syndrome due to cystic duct remnant are described. All underwent laparoscopic cholecystectomy and one was converted to open. The patients presented with pain 10 months to 9 years post-cholecystectomy and investigations demonstrated cystic duct remnant. All patients underwent successful resection with resolution of symptoms. In this era of laparoscopic surgery, where surgery favors a long cystic duct remnant, we should be aware of cystic duct stones as a possible cause of postcholecystectomy syndrome. This report highlights magnetic resonance cholangiopancreatography as the optimal method for evaluating the biliary tract in these cases. 相似文献
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The authors report the case of a 52-year-old woman who presented with an anterior neck mass, which was excised and diagnosed at pathological examination as papillary adenocarcinoma arising in a thyroglossal duct remnant. Echography and computed axial tomography of the neck were utilized to exclude the presence of thyroid gland neoplasia. The patient was discharged on suppressive thyroid therapy, and after follow-up examination at two years was found to be free of recurrent neoplastic lesion. 相似文献
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Xanthogranulomatous abscess of a Mullerian duct remnant 总被引:2,自引:0,他引:2
Dr. Michael Davis M.D. Mark E. Whitley M.D. Abida K. Haque M.D. Cecilia Fenoglio-Preiser M.D. Robert Waterman Ph.D. 《Diseases of the colon and rectum》1986,29(11):755-759
A rare example of xanthogranulomatous inflammatory mass and abscess of a Mullerian duct remnant involving the anorectal area
is reported. A barium enema showed a bilobed precoccygeal mass of moderate size involving the posterior aspect of the distal
rectum. Computed tomography (CT) showed two nonfatty, round masses, one of which contained a small central cystic area. The
other mass had a homogeneous appearance and was believed to be in the wall of the rectum. The pathologic specimen showed organizing
abscesses and a chronic xanthogranulomatous inflammation in tissue compatible with urogenital tissue, presumably a Mullerian
duct remnant. This is the first documented report of anorectal xanthogranulomatous abscess in a Mullerian duct remnant with
radiologic findings and histopathologic correlation. Though rare, this lesion should be considered in the differential diagnosis
of extrinsic and intramural rectal masses seen on barium enema and CT examinations. 相似文献
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The recently described but little-recognized entity of “pseudocarcinomatous invasion” or “epithelial misplacement” in adenomatous
polyps of the colon and rectum is discussed, with the presentation of a recent case. The entity's clinical characteristics,
histologic features, and pathogenesis are described. The implications of recognizing such a lesion are emphasized. 相似文献
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BACKGROUND/AIMS: Occlusion of the pancreatic duct system has been used to prevent pancreatic leakage by abolishing pancreatic exocrine secretion in pancreatic surgery. However, ductal occlusion has not proved satisfactory for preventing pancreatic fistulas in pancreaticoduodenectomy (PD). METHODOLOGY: Pancreatic duct occlusion with a watertight drainage system around the pancreatic stump was performed following extended PD in 17 patients with (n=12) or without (n=5) a dilated pancreatic duct. RESULTS: Transient pancreatitis during the early postoperative period occurred in all patients with a nondilated pancreatic duct. No patient developed pancreatic fistula or any other serious complication in both groups. CONCLUSIONS: Pancreatic duct occlusion may minimize the risk of pancreatic leakage in patients with a nondilated pancreatic duct and a normal pancreas as well as in those with a dilated, obstructed pancreatic duct without compromising the postoperative quality of life. This is a safe and reliable technique for managing the pancreatic remnant in patients undergoing extended PD for advanced pancreaticobiliary malignancy. 相似文献