Abstract
症例は67歳，男性．心窩部痛を認め，加療目的に当科受診となった．画像検査で肝内胆管・総胆管の拡張と胆嚢管の壁肥厚を認め，ERCPにて乳頭より多量のゼリー状緑色粘液の排出が確認された．さらに，経口胆道内視鏡にて胆嚢管口に緑色粘液を認め，胆汁細胞診はClass V （adenocarcinoma）であった．胆管の粘膜表面には明らかな異常所見を認めなかった．以上より粘液産生胆嚢管癌と診断し，肝床部分切除を伴う胆嚢摘出術・肝外胆管切除・D2リンパ節郭清・胆管空腸吻合術を施行した．胆嚢管に全周性の境界不明瞭で表面乳頭状の璧肥厚所見を認め，胆嚢内は粘稠な緑色ゼリー状粘液で充満していた．組織学的には深達度はssの高分化型腺癌であり，リンパ節転移は認めず，stage IIであった．今回，われわれは粘液産生胆嚢管癌を，経口胆道内視鏡にて術前診断しえた1例を経験したので，報告する．
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