A Case of Mucin-hypersecreting Gallbladder Papillary Carcinoma Manifested as Obstructive Jaundice / 대한소화기내시경학회지

Biliary papillomatosis (BP) is a rare disease that is classified as either the mucin-hypersecreting type or nonmucin-secreting type. Typical papillomas of the biliary tree mainly involve intrahepatic bile ducts or both intra- and extrahepatic bile ducts. The isolated involvement of the extrahepatic bile duct is rare, and there is no report of BP confined to the gallbladder in Korea. We report a case of a 50-year-old man who developed obstructive jaundice due to hypersecreted mucin from papillomas of the gallbladder.

Isolated Caudate Lobectomy with Bile Duct Resection Performed in a Patient with Type IV Hilar Bile Duct Cancer

The prognosis of hilar bile duct cancer has been improved by extensive curative resection, but limited functional reserve of the liver occasionally does not permit such a major hepatectomy. We report a type IV hilar bile duct cancer case undergone isolated caudate lobectomy as a limited but curative resection, in whom the indocyanine green retention test at 15 minutes revealed 23.9% despite long-term biliary decompression and the whole liver was rather atrophic. Complete removal of the Spiegel lobe, paracaval portion, and caudate process combined with hilar bile duct resection made 3 right and 4 left intrahepatic duct openings, which were reconstructed as a whole at each side of transection plane after ductoplasty. The patient recovered uneventfully. Although surgical technique for isolated caudate lobectomy must be more difficult comparing with other anatomical hepatectomy, but it can be a ultimate technique of limited curative resection for advanced hilar bile duct cancer patients with decreased hepatic reserve. Comprehension to the anatomy of the caudate lobe is a prerequisite for its resection, thus we discussed it in detail.

Tracheoesophageal Fistula in a Patient with T-cell Lymphoma / 대한소화기내시경학회지

Although lymphoma may involve any part of gastrointestinal tract either primary or secondary, esophageal involvement is rare. Secondary esopahgeal involvement of lymphoma is showing an incidence between 0% and 6% with autopsy series and lesser then 1% in living patients. The occurrence of a tracheoesophageal fistula(TEF) in patient with lymphoma is even more rare. We describe one case of TEF due to secondary esophageal invasion of T-cell lympboma and review the literature, with particular attention to chest CT and esophagoscopic finding, and endoscopic biopsy result.

Three Cases of Anomalous Drainage of Common Bile Duct into the Duodenal Bulb / 대한소화기내시경학회지

Classic anatomical descriptions state that the common bile duct enters to the medial border of the second part of duodenum. Isolated case reports of the common bile duct in other sites, including the fourth part of duodenum, the pyloric canal, stomach, and the duodenal bulb, have appeared in the literature. We report three cases of anomalous drainage of the common bile duct into duodenal bulb, which caused recurrent cholangitis and peptic ulcer. All patients required choledochoenteric anastomosis to relieve their syrnptoms.