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A 55-year-old man had a one-month history of painless jaundice. Endoscopic ultrasonography showed a 2.5-cm lesion in the head of the pancreas. Biopsy of the pancreas confirmed the diagnosis of adenocarcinoma. A digital subtraction angiographic evaluation showed a markedly enlarged gallbladder, extending far below the costal margin. A pylorus-sparing Whipple's procedure was performed, and the patient recovered without serious complications. The resected gallbladder measured 14 by 5 cm (normal size, 7 to 10 by 3 cm) and contained no stones.
Although Ludwig Courvoisier's famous observations on the relation between obstruction of the common bile duct and the size of the . . . [Full Text of this Article] |
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