| Autor: |
Montalvo-Javé EE; Departamento de Gastroenterología, Fundación Clínica Médica Sur, Mexico City, Mexico; Servicio de Cirugía General, Unidad 304, Hospital General de México. Mexico City, Mexico; Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico., Chablé-Montero F; Departamento de Patología, Fundación Clínica Médica Sur, Mexico City, Mexico., Toapanta-Yanchapaxi LN; Departamento de Gastroenterología, Fundación Clínica Médica Sur, Mexico City, Mexico., Rojas-Mendoza F; Departamento de Gastroenterología, Fundación Clínica Médica Sur, Mexico City, Mexico., López-Caballero C; Facultad Mexicana de Medicina, Universidad la Salle (ULSA), Mexico City, Mexico., Roca-Cabrera ML; Departamento de Anestesiología y Terapia Respiratoria. Fundación y Clínica Médica Sur, Mexico City, Mexico., Mendoza-Barrera GE; Departamento de Cirugía, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico. |
| Abstrakt: |
We report the case of a 37-year-old woman with no relevant medical history. She was admitted to the hospital for epigastric pain related with food intake for 4 days; the pain did not improve with symptomatic management. A laparoscopic cholecystectomy due to acute lithiasic cholecystitis was performed. However, after 4 days, postoperative painless jaundice was evident; thus, endoscopic retrograde cholangiopancreatography was performed, which revealed an amputation of intrapancreatic common bile duct, as well as secondary intra- and extrahepatic bile duct dilatation. Brushing of the distal portion of the common bile duct revealed a well-differentiated adenocarcinoma. Therefore, a Whipple procedure with pylorus preservation was performed. Pathologic diagnosis of a papillary in situ adenocarcinoma with two microscopic foci of microinvasion was established. The pathologic Tumor-Node-Metastasis (TNM) stage was pT1, pN0, pM0, R0. The patient is asymptomatic and disease-free 24 months after surgery. In general, adenocarcinomas of the extrahepatic bile ducts are uncommon and have a poor prognosis. However, symptomatic patients with early disease stages are even rarer and can be cured surgically. |
