Preoperatively Diagnosed Asymptomatic Early Extrahepatic Bile Duct Cancer / 대한소화기내시경학회지

ABSTRACT

Cholangiocarcinoma is usually diagnosed at the advanced stage because early symptoms and signs are relatively infrequent. The preoperative diagnosis of early extrahepatic bile duct cancer in common bile duct is uncommon. Also, an extrahepatic bile duct cancer arising from the lower portion of the common bile duct is usually papillary and rarely nodular or sclerosing. We decribe a case, preoperatively diagnosed as early extrahepatic bile duct cancer in lower portion of common bile duct, nodular type on endoscopic retrograde cholangiography. It was incidentally detected by the slight elevation of gamma-glutamyl transpeptidase without any symptoms. An endoscopic retrograde cholangiography showed abrupt narrowing of the intrapancreatic portion of the common bile duct with irregular and nodular filling defect. The lesion was confined to mucosa on the endoscopic ultrasonography. This patient was diagnosed as early extrahepatic bile duct cancer and underwent Whipple's operation. A histopathologic examination of resected specimen revealed to be moderately differentiated adenocarcinoma at stage 1 (T1N0Mo) in the extrahepatic bile duct.