Surgical treatment of malignant biliary papillomatosis invading adjacent organs: A case report

Figure 1 Preoperative body examination and magnetic resonance imaging. A: A T-tube for biliary drainage with grey-white, hyperplastic granulation tissue (with a stench) surrounding the tube; B: Magnetic resonance imaging demonstrates a huge mass in the gallbladder area, embedding in the common bile duct where a drainage tube was seen.

Figure 2 Surgical procedure. A: Dissecting the abdominal wall around the T-tube step by step; B: Choledochojejunostomy, gastrointestinal anastomosis, and intestinal anastomosis were performed after removing all lesions; C: Closing the incision by transferring rectus abdominis and external oblique muscle flap; D: The en bloc specimen of the liver, common bile duct, duodenum, partial stomach, spleen, and pancreas was removed.

Figure 3 Histological examination (magnification, × 400) revealed a moderately differentiated adenocarcinoma originating from the biliary system.

Figure 4 Surgical incision at 35 mo after operation. She was asymptomatic and in good physical condition.