CASE 649: CHOLANGIOCARCINOMA, Dr PHAN THANH HẢI, Dr VÕ THỊ THANH THẢO, Dr TRẦN CHÍ ĐỦ, Dr NGUYỄN THÀNH ĐĂNG, MEDIC MEDICAL CENTER, HCMC, VIET NAM.

 A  68 year-old male patient with jaundice in ruling out of head of pancreas tumor from Tra vinh province went to Medic Center for an exact diagnosis before a surgical treatment.

Ultrasound ruled out pancreatic tumor and noted intrahepatic bile duct dilatation and 2 sides pleuresia. Gallbladder was not big with some sludge.  Wall of bile duct thickening # 6-7mm, hyperechoic, CBD diameter 1.24mm existed 0.66--1.2 mm bile sludge at the beginning of CBD. Sign of bile duct tumor was unclear.

Later biliary MRI performed and the result was a tumoral infiltration in bile duct  that made collapse biled duct at the hepatic umbilicus leading to dilatation of intrahepatic bile ducts. Maybe there was an other thought about of stricture of bile duct due to cholangitis.

Surgery was done that detected bile duct tumor #1x2 cm.  Removed bile duct tumor, GB,  and  connecting hepatic duct  to jejunum by Roux-en-Y. Anapath was CholangioCarcinoma grade 2 invasive.