A 42 Year-old male visited our hospital for a detailed examination of the gallbladder. Abdominal ultrasonography (US) revealed the wall thickening with high echo spots in the inner layer of the gallbladder, and no dilatation of the common bile duct. Endoscopic ultrasonography (EUS) showed papillomatous cholesterosis in the gallbladder, and the abnormal connection of the common bile duct and main pancreatic duct located well within the pancreatic parenchyma. From these results, we were able to diagnose anomalous arrangement of the pancreaticobiliary duct without dilatation of the bile duct along with papillomatous cholesterosis of the gallbladder. Cholecystectomy and resection of the common bile duct were performed. It is suggested that EUS should be (inevitably) applied in case of papillomatous gallbladder with wall thickening for the early detection of anomalous arrangements of the pancreaticobiliary duct.
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