Abstract
A 73-year-old woman was referred to our institution for a gallbladder tumor detected by abdominal US examination during a routine checkup. CT demonstrated papillary lesions in the gallbladder with enhancement (A), and EUS clearly showed papillary lesions with several striations of variable width (B). Duodenal endoscopy revealed mucin extravasating from the ampulla of Vater. We performed endoscopic nasogallbladder drainage (ENGBD). The lesion appeared as an irregular, papillary-like filling defect (C) on a contrast study performed through the ENGBD tube. On ERCP, a catheter (Tandem XL; Boston Scientific, Natick, Mass) was inserted to the origin of the cystic duct, followed by passage of a guidewire. Once positioning was secured in
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