Gallbladder carcinoma with tumor thrombus in common bile duct: an unusual way of growing invasion

Abstract

ObjectiveTo summarize the experience of diagnosis and surgical treatment for a rare invasion manner of gallbladder carcinoma, which was combined with tumor thrombus in common bile duct (CBD). MethodsBetween February 2003 and January 2005, 3 patients with gallbladder carcinoma who were identified of tumor thrombus in common bile duct in surgical procedure were retrospectively analyzed. ResultsAbdominal ultrasound and magnetic resonance cholangiopancreatography (MRCP) were used for preoperative diagnosis. All 3 patients were given radical operations, which were composed of cholecystectomy, resection of the extrahepatic biliary duct, cuniform hepatectomy of gallbladder bed, skeletonization of the hepatoduodenal ligament, hilar choledochojejunostomy, and clearance of tumor thrombus from bile duct. Three patients were recovered well after surgery, which were respectively alive for 30 months, 17 months and 23 months without tumor recurrence, and 58 months, 41 months and 40 months for survival time after operation. ConclusionGallbladder carcinoma with tumor thrombus in common bile duct was very rare but with relatively special clinical manifestation and characteristic radiography manifestation. MRCP was one of the most potent diagnostic method. The prognosis of gallbladder carcinoma with tumor thrombus in common bile duct after surgical procedure was apparently better than gallbladder carcinoma with invasion of hilar tissues. Radical operation was feasible and safe for obtaining longer survival.