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Abstract: In this case, the patient came to the clinic with unexplained jaundice with upper abdominal discomfort. Bile duct cancer is a common malignant tumor of the biliary system, and the symptoms are mainly jaundice. Early surgical treatment is chosen to achieve better results after radical removal of the tumor.
[Basic Information] Male, 70 years old
Disease Type】Cholangiocarcinoma
Hospital】Liaocheng People’s Hospital
Consultation time】November 2021
Treatment plan】Surgical treatment (pancreaticoduodenectomy)
Treatment Period】Hospitalization for 15 days, regular follow-up after surgery
Effectiveness】The tumor was radically removed and recovered well after surgery.
I. Initial consultation
The patient is a male, 70 years old. 6 days ago, he started to have epigastric distension and fever without any obvious cause, accompanied by yellow skin and strong tea-colored urine. Outpatient liver function tests showed that transaminases were elevated and bilirubin was elevated, suggesting obstructive jaundice, and then the abdominal ultrasound was completed, and the test results suggested dilated common bile ducts in the hepatoportal area.
II. Treatment history
After admission, the patient underwent intensive magnetic resonance examination, which indicated cholangiocarcinoma, and no other distant metastasis or vascular invasion was found, and the tumor marker CA199 was significantly elevated. After careful consideration, the patient’s family agreed to undergo surgery. The operation was very smooth and the postoperative pathology confirmed that it was bile duct cancer, and the surrounding margins were all negative, indicating that the tumor was removed very cleanly. After the operation, the patient was given regular symptomatic supportive treatment. After the operation, the patient’s liver function gradually normalized, and the tumor marker CA199 also returned to normal.
III. Treatment effect
The patient’s postoperative pathology confirmed that it was cholangiocarcinoma, and the margins were negative, indicating that the surgery was very clean. The patient also gradually resumed normal diet, indicating that the postoperative recovery was very smooth. The patient was discharged at 15 days of hospitalization, and was advised to have regular postoperative follow-up. At present, there is no obvious recurrence of the tumor, the general condition is good, the liver function is normal, and the tumor marker CA199 is not increased, but always within the normal range, the patient and his family are very satisfied with the treatment effect.
IV. Notes
We are very glad that the patient’s condition was controlled after the surgical treatment. However, the patient was advised to pay attention to the control of diet after discharge, to eat less and more meals, and to try to eat some good digestible and light food, and avoid eating greasy and spicy stimulating food. After discharge, the patient can gradually increase exercise, mainly aerobic exercise, such as walking, playing Tai Chi, etc., to improve their resistance. In addition, patients should have regular check-ups to detect the recurrence of tumor at an early stage so as to get better treatment effect.
V. Personal insight
The incidence of bile duct cancer is increasing, which is related to daily living habits, environmental factors and genetic factors. The most common symptom of cholangiocarcinoma is jaundice. If jaundice and right upper abdominal discomfort occur, one should seek medical treatment promptly to prevent delaying the disease. In the early stage of bile duct cancer, surgery is generally preferred, which is more effective than conservative treatment such as chemotherapy. As in this case, the patient underwent radical surgery in time after early detection of bile duct cancer and obtained relatively good treatment results.