Li CK, Cao RR, Su DS, Ming J, Li YC, Shao XD, Qi XS. Diagnosis of bile duct metastasis from gastric cancer by endoscopic retrograde cholangiopancreatography combined with choledochoscopy: A case report. World J Gastrointest Surg 2026; 18(1): 112416 [PMID: 41695845 DOI: 10.4240/wjgs.v18.i1.112416]
Corresponding Author of This Article
Xing-Shun Qi, PhD, Professor, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110840, Liaoning Province, China. xingshunqi@126.com
Research Domain of This Article
Oncology
Article-Type of This Article
Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Feb 17, 2026
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Journal Information of This Article
Publication Name
World Journal of Gastrointestinal Surgery
ISSN
1948-9366
Publisher of This Article
Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Li CK, Cao RR, Su DS, Ming J, Li YC, Shao XD, Qi XS. Diagnosis of bile duct metastasis from gastric cancer by endoscopic retrograde cholangiopancreatography combined with choledochoscopy: A case report. World J Gastrointest Surg 2026; 18(1): 112416 [PMID: 41695845 DOI: 10.4240/wjgs.v18.i1.112416]
Cheng-Kun Li, Rong-Rong Cao, Dong-Shuai Su, Xiao-Dong Shao, Xing-Shun Qi, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Dong-Shuai Su, Department of Gastroenterology, The 963rd Hospital of the Joint Logistics Support Force of the Chinese People’s Liberation Army, Jiamusi 154000, Heilongjiang Province, China
Jian Ming, Ying-Chun Li, Department of Pathology, General Hospital of Northern Theater Command, Shenyang 110840, Liaoning Province, China
Co-first authors: Cheng-Kun Li and Rong-Rong Cao.
Co-corresponding authors: Xiao-Dong Shao and Xing-Shun Qi.
Author contributions: Li CK was involved in visualization; Li CK and Cao RR contributed equally to this article, they are the co-first authors of this manuscript; Li CK, Cao RR, Su DS, Ming J, and Li YC participated in investigation; Li CK, Cao RR, Su DS, Ming J, Li YC, and Qi XS participated in writing; Su DS, Ming J, and Li YC contributed to data curation; Shao XD and Qi XS were responsible for conceptualization and supervision, they contributed equally to this article, they are the co-corresponding authors of this manuscript; and all authors thoroughly reviewed and endorsed the final manuscript.
Supported by the Independent Research Funding of General Hospital of Northern Theater Command, No. ZZKY2024018.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Corresponding author: Xing-Shun Qi, PhD, Professor, Department of Gastroenterology, General Hospital of Northern Theater Command, No. 83 Wenhua Road, Shenyang 110840, Liaoning Province, China. xingshunqi@126.com
Received: July 28, 2025 Revised: August 26, 2025 Accepted: November 12, 2025 Published online: January 27, 2026 Processing time: 179 Days and 4.4 Hours
Abstract
BACKGROUND
Bile duct metastasis from gastric cancer is a very rare secondary cancer, which can cause biliary obstruction.
CASE SUMMARY
A 42-year-old male presented with right upper abdominal discomfort and jaundice after a total gastrectomy for poorly differentiated gastric adenocarcinoma. He underwent comprehensive laboratory tests and imaging examinations, and ultimately endoscopic retrograde cholangiopancreatography with choledochoscopy was performed. Stenoses were identified in the common hepatic duct and the common bile duct. Under choledochoscopic guidance, biopsy was taken from the bile duct tissue at the stenotic site. Then, a plastic stent was placed across the stenosis. Pathological examination with immunohistochemical staining confirmed poorly differentiated adenocarcinoma of the common bile duct. Following the procedure, the patient’s liver function gradually improved, and his abdominal discomfort was also relieved.
CONCLUSION
This case indicates the possibility of bile duct metastasis from gastric cancer and highlights the necessity of endoscopic retrograde cholangiopancreatography combined with choledochoscopy in patients with suspicious malignant biliary obstruction.
Core Tip: Bile duct metastasis from gastric cancer is a very rare form of secondary malignancy that can lead to biliary obstruction. We herein report a case who developed right upper abdominal discomfort and jaundice following total gastrectomy for poorly differentiated gastric adenocarcinoma. Subsequently, endoscopic retrograde cholangiopancreatography with choledochoscopy identified poorly differentiated adenocarcinoma in the common bile duct. This case indicates the possibility of bile duct metastasis from gastric cancer and highlights the necessity of endoscopic retrograde cholangiopancreatography combined with choledochoscopy in patients with suspected malignant biliary obstruction.
