During the course of chemoradiation the transhepatic stent was replaced by an endoscopically placed internal stent because of patient discomfort with the percutaneous tube and to increase effectiveness of drainage.
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CT scan was repeated after chemoradiation was completed. The gallbladder had become thickened and dilated over the course of therapy. The patient was taken to the operating room for attempted resection with hepaticoenteric anastomosis. After careful exploration it was determined that safe resection was not possible and the procedure was terminated without injury to the patient. The postoperative plan was to replace the plastic stent with an expandable permanent metal stent.
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