2000, Number 4
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ABSTRACTObjective: To describe a case of papillary carcinoma of the biliary tract.
Setting: Third level health care hospital.
Case description: A 77 years old man, who was admitted to the hospital with a diagnosis of jaundice syndrome, with two months evolution, without abdominal pain, fever of 38ºC, choluria and acholia, without weight loss. Hepatic function tests revealed: hyperbilirubinemia of 14.1 mg/dl, indirect of 10.1 mg/dl, alkaline phosphatase of 350 U, the remainder tests were normal. Imaging studies (ultrasound, retrograde endoscopic cholangiography, and abdominal computed tomography) revealed dilation of the intrahepatic biliary tract, obstruction at the confluence of the hepatic ducts due to a tumor extending from the intrahepatic biliary tract to the proximal extrahepatic tract. He was surgically explored, with the following findings: cholestatic liver, increase of the biliary tract diameter above the insertion of the cystic duct into the comun hepatic duct. During biliary tract exploration, a cerebroid and polypoid material was extracted, which was sent for histopathological examination. A T catheter was implanted, which has been kept closed for one year. The histopathologic report was of papillary adenocarcinoma moderately differentiated. The patient has been under surveillance for two years with laboratory tests and cholangiographies through the T catheter.
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