[原著]胆嚢粘膜に肉眼的異常を認めなかった胆嚢進行癌の1例

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概要

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• One case of advanced carcinoma of the gallbladder without macroscopic abnormality in its mucosa is reported. A 65-year-old woman was admitted to the Second Department of Surgery, College of Health Sciences, University of the Ryukyus on January 10,1979, complaining of intermittent epigastric pain of six months' duration. Percutaneous transhepatic chorangiogram revealed several stones in gallbladder and common bile duct. Laparotomy was performed on January 26,1979. The gallbladder was in normal position and of normal size and shape. The serosa was normal. Palpation of the fundus of the gallbladder revealed little finger tip-sized thickening of the wall, which was suspected to be adenomyomatosis at first. There were large and firm lymph nodes located at hepatoduodenal ligament, omentum and mesocolon. Cholecystectomy, choledochotomy and T-tube drainage were performed. On opening the removed gallbladder, the thicked portion of the wall was found to be firm and solid without hyperplasia of the Rokitansky-Aschoff sinus. Frozen section of the thicked portion of the wall and swelled lymph nodes were examined, the pathologic report was adenocarcinoma in all specimens. Radical operation for the carcinoma of the gallbladder was, therefore, abandoned. Since small neoplasma of the gallbladder may easily be overlooked by the surgeon at the time of operation, it must be avoided by opening, inspecting and palpating the gallbladder in the operating room and obtaining frozen section of suspected areas.

• 琉球大学保健学部の論文

琉球大学保健学部 | 論文

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