A CASE OF INTRAHEPATIC CHOLELITHIASIS WITH CHOLANGIOCARCINOMA SURVIVING FOR MORE THAN THREE YEARS AFTER OPERATION

It has been known that intrahepatic cholelithiaiss is frequently associated with cholangiocarcinoma and the prognosis is very poor in that case. We have experienced such a case surviving for more than three years after operation. A 55-year-old woman complaining of an upper abdominal pain was found having intrahepatic gallstones by endoscopic retrograde cholangiography and abdominal computed tomography. The lateral segment of the left lobe of liver was resected and histologic sections revealed associated chlangiocarcinoma whitch extended to surgical margin. Forty-three days later, the medial segment of the left lobe was resected to remove residual carcinoma, though cancerous tissue was not detected histologically. The patient has been well for more than three years after the operation. Significance of exact clinical investigation and pertinent operation should be emphasized in the management of intrahepatic cholelithiasis with a long history of the disease, especially in a case with recurrent infections.