Abstract：
An 83-year-old Japanese man who underwent cholecystectomy for cholecystolithiasis 17 years ago visited our hospital owing to epigastric pain. He was initially diagnosed with choledocholithiasis and acute cholangitis following white blood cell, C-reactive protein, total bilirubin, alkaline phosphatase, and γ-glutamyltranspeptidase level elevations along with common bile duct stones on computed tomography (CT). Moreover, CT, magnetic resonance imaging, endoscopic retrograde cholangiography (ERC), and endoscopic ultrasonography (EUS) also revealed a 2-cm-diameter mass arising from the remnant cystic duct. The cytology of the bile at the time of ERC was not conclusive. However, EUS-assisted fine needle aspiration (EUS-FNA) of the mass confirmed the diagnosis of adenocarcinoma of the remnant cystic duct. The patient underwent extrahepatic bile duct resection. Cystic duct carcinoma following cholecystectomy is rare. We report a case diagnosed by EUS-FNA.
摘要：
一名83岁的日本男子17年前因胆囊结石症接受了胆囊切除术，因上腹痛来我院就诊。他最初被诊断为胆总管结石和白细胞后急性胆管炎，C反应蛋白,总胆红素,碱性磷酸酶,在计算机断层扫描（CT）上，γ-谷氨酰转肽酶水平升高以及胆总管结石。此外，CT,磁共振成像，内镜逆行胆管造影(ERC),和内镜超声检查（EUS）也发现了一个直径为2厘米的肿块，来自残余的胆囊管。ERC时胆汁的细胞学检查尚无定论。然而,EUS辅助的细针穿刺（EUS-FNA）证实了残余胆囊管腺癌的诊断。患者接受肝外胆管切除术。胆囊切除术后的囊管癌很少见。我们报告一例EUS-FNA诊断的病例。
