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Introduction and importance: Cystadenoma and cystadenocarcinoma of the biliary duct remain a rare diagnosis, the localization is intrahepatic in 97% of the cases and extrahepatic in 3%of them [1]. Cystadenocarcinoma of the gallbladder is the rarest localization, it's usually diagnosed late because of the poor symptoms and the nonspecific lesions in the different imaging.Only hundreds of cases have been reported for cystadenocarcinoma of the gallbladder.This case report has been reported in line with the SCARE Criteria. Case presentation: We present a 70-year-old woman, with no family or personal history, who was complaining of pain in the right hypochondrium and an altered general well-being, with no other clinical abnormalities.The imaging including abdominal sonography, CT scan, and MRI concluded at a budding lesion formed in the gallbladder wall which measured 65 × 15mm.Cancer of the gallbladder was suspected and the patient was operated. A resection of segment s4b and 5 of the liver was performed with lymphadenectomy. The post-operative clinical course was uneventful.The diagnosis of cystadenocarcinoma of the gallbladder was confirmed on an anatomopathological exam of the specimen. Conclusion: Cystadenocarcinoma is a rare diagnosis.There are no specific symptoms or lesions at the imaging.The confirmation is obtained on an anatomopathological study of the specimen.
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AIM OF THE STUDY: To report a new series of medial pancreatectomy (MP), with analysis of early and long-term results. PATIENTS AND METHODS: From 1990 to 1999, 11 patients (mean age = 53 years, extremes: 28-70)--including 10 non-diabetic--underwent MP for neuroendocrine tumor (n = 5), intraductal papillary mucinous tumor (IPMT) (n = 3), serous cystadenoma, metastasis from renal cell carcinoma, and focal pancreatitis. The procedure included medial resection of variable extent, frozen section, and suture of the cephalic stump. The caudal stump was either anastomosed to the posterior gastric wall (n = 9), or closed when atrophic or very small (n = 2). RESULTS: The mean length of resection was 7 cm (extremes: 4-15). The diagnosis suspected preoperatively was confirmed in 10 cases. In one patient, a suspected adenocarcinoma was actually a focal pancreatitis. No postoperative death occurred. Seven patients experienced complications: one delayed gastric emptying and 6 pancreatic fistulas (54%), including 3 associated with intraabdominal collection. Two patients were reoperated to drain a pancreatic fistula. The mean hospital stay was 14 days (extremes: 10-21) without complications, and 30 days (extremes: 11-90) after complications. After a mean follow-up of 45 months (extremes: 7-130), only one patient initially non-diabetic experienced post-operative diabetes and needs enzyme therapy after a 15 cm-resection for IPMT. No patient developed isolated intrapancreatic recurrence. CONCLUSIONS: MP preserves efficiently pancreatic function and is associated with a low risk of intrapancreatic recurrence. Conversely, MP is associated with an high risk of pancreatic fistula.