Gallstone disease masking malignant bile duct tumors: A rare but importantcoincidence

We report 4 recent cases of malignant tumors of the common bile duct which were misdiagnosed as benign gallstone disease on preoperative US and CT sca n and underwent subsequent laparoscopic or conventional cholecystectomy. Al l patients were admitted with the classical signs of symptomatic gallstone disease or acute cholecystitis. The diagnosis was based on physical examina tion and US examination of the abdomen. Laparoscopic cholecystectomy was pe rformed in 3 patients while the remaining patient underwent open cholecyste ctomy because of cardiac problems. Three patients were readmitted after a m edian of 18 (range 4-32) weeks with symptoms of cholestasis. ERCP investiga tions now revealed malignant bile duct tumors. This report stresses the poi nt that gallbladder disease may mask additional underlying malignant bile d uct tumors which may be overlooked in the absence of intraoperative cholang iography or preoperative ERCP. Copyright (C) 2000 S. Karger AG, Basel.