Diagnosis of bile duct metastasis from gastric cancer by endoscopic retrograde cholangiopancreatography combined with choledochoscopy: A case report

doi:10.4240/wjgs.v18.i1.112416

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World Journal of Gastrointestinal Surgery

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1948-9366

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Case Report

World J Gastrointest Surg. Jan 27, 2026; 18(1): 112416
Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.112416

Diagnosis of bile duct metastasis from gastric cancer by endoscopic retrograde cholangiopancreatography combined with choledochoscopy: A case report

Cheng-Kun Li, Rong-Rong Cao, Dong-Shuai Su, Jian Ming, Ying-Chun Li, Xiao-Dong Shao, Xing-Shun Qi

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 963^rd 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).

Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/

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.

Keywords: Bile duct metastasis from gastric cancer; Choledochoscopy; Endoscopic retrograde cholangiopancreatography; Biliary obstruction; Case report

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.