The neck of the gallbladder was thickened and fibrotic. The neck of the gallbladder contained well differentiated adenocarcinoma involving the serosa.
Surgeon: Mario Diaz
Chief Resident: Alex Chao
Carcinoma of the tail of the pancreas is commonly asymptomatic for long periods before discovery and is frequently too large and invasive to be resected either for cure or palliation when found. This patient's lesion was discovered fortuitously because of his cholecystitis, and was therefore small enough to allow surgical resection. Pancreatic cancer is most commonly of duct cell origin and is seen in the older age group. Diabetes, smoking and alcohol intake have been correlated with the disease. Pain is the most common presenting symptom, followed by weight loss. Lesions of the head which cause biliary obstruction present earlier than body and tail lesions. he pain from the latter may be located in the left upper quadrant and back. Although this patient had two foci of metastatic
disease, resection was beneficial, if not for cure, to decrease tumor load and to preclude the debilitating pain patients with unresected pancreatic tumors develop as the tumor grows.
Bradley, EL III and Zeppa, R, in Sabiston, DC Jr., Textbook of Surgery, WB Saunders, 13th ed., 1986: 1194.