Hilar cholangiocarcinoma is defined as a malignant neoplasm involving right and left main hepatic ducts and/or its confluency. The disease is more prevalent in East Asia including Korea than Western countries and it may be due to the facts that hepatolithiasis, clonorchiasis and congenital anomaly of bile ducts are more frequent in this region. In this review, we will discuss about radiologic, endoscopic, and TNM staging along with preoperative assessment for surgical strategy in patients with hilar cholangiocarcinoma.
Bile Duct Neoplasms/*diagnosis/surgery ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/surgery ; Humans

Bile Duct Neoplasms ; diagnosis ; surgery ; Bile Ducts, Intrahepatic ; Cholangiocarcinoma ; diagnosis ; surgery ; Hepatectomy ; Humans ; Liver Transplantation ; Prognosis

No abstract available.
Bile Duct Neoplasms/*diagnosis/mortality/surgery ; *Bile Ducts, Extrahepatic ; Humans ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis

No abstract available.
Bile Duct Neoplasms/diagnosis/*pathology/surgery ; Bile Ducts/*pathology/surgery ; Cystadenocarcinoma/diagnosis/*pathology/surgery ; Female ; Humans ; Middle Aged ; Prognosis

Majority of malignant neoplasms arising from the extrahepatic bile duct are adenocarcinomas. Carcinoid tumors at this site are extremely rare. We report a 67-year-old woman with malignant carcinoid tumor of the common bile duct. She presented with obstructive jaundice of 1 week's duration. Abdominal CT and ERCP revealed a common bile duct mass. She underwent Whipple's operation and was diagnosed as malignant carcinoid tumor histologically and immunohistochemically.
Aged ; Carcinoid Tumor/*diagnosis/surgery ; Common Bile Duct Neoplasms/*diagnosis/surgery ; Female ; Humans

Leiomyomas, originating in the bile duct, are very rare, and only few cases have been reported in the literature. We experienced a case of leiomyoma of the distal common bile duct, mimicking bile duct cancer. A 39-year-old woman presented with intermittent jaundice and general weakness for three months. Clinical profiles showed obstructive jaundice, and the abdominal computed tomography and cholangiography revealed diffuse bile duct dilatation with distal common bile duct stricture. A pylorus-preserving pancreaticoduodenectomy was performed and the pathologic specimen disclosed leiomyoma of the common bile duct accompanying severe fibrosis. This is the first case of leiomyoma in the bile duct reported in Korea.
Adult ; Common Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Female ; Humans ; Leiomyoma/*diagnosis/pathology/surgery ; Pancreaticoduodenectomy

Liver resection with extrahepatic bile duct resection, wide lymph node dissection and caudate lobectomy has become the standard treatment for patients with hilar cholangiocarcinoma. More extended surgery, such as hepatopancreatoduodenectomy, combined portal vein and liver resection, has been accepted for treatment. Such aggressive resection could only offers better chance of long-term survival, but postoperative morbidity and mortality is still high. Various preoperative diagnostic and management modalities including PTBD, PTCS, angiography, MR angiography, MR cholangiography, DCT, CT angiography and PTPE are very important for optimal treatment and reduced mortality. It is recommended that surgeons, physicians, endoscopists, and radiologists, including interventional radiologists should perform the diagnosis and preoperative management of patients with hilar cholangiocarcinoma in a concerted way.
Bile Duct Neoplasms/*diagnosis/surgery ; *Bile Ducts, Intrahepatic ; Cholangiocarcinoma/*diagnosis/surgery ; Hepatectomy/methods ; Humans ; Lymph Node Excision

Here, a case of a patient with incidental finding of a carcinoid tumor of the ampulla of Vater, who was treated with endoscopic snare papillectomy, is reported. A 62-year-old male was admitted to our hospital due to a carcinoid tumor of the ampulla of Vater, which was found during follow-up endoscopy after an endoscopic mucosal resection of early gastric cancer. No lymphadenopathy or visceral metastasis was found on an abdominal CT scan, In-111 octerotide scan and EUS. The ampulla was then en bloc removed by endoscopic snare papillectomy. The resected specimen revealed a 0.7 X 0.5 X 0.1 cm sized carcinoid tumor. All margins of resection were negative for tumor. After six months of follow-up, there was no evidence of recurrence and metastasis, either endoscopically or radiologically. To our knowledge, this case is the first report of an ampullary carcinoid tumor treated by endoscopic snare papillectomy in Korea.
Ampulla of Vater/pathology/*surgery ; Bile Duct Neoplasms/diagnosis/*surgery ; Carcinoid Tumor/diagnosis/*surgery ; *Duodenoscopy ; Electrosurgery/*methods ; Humans ; Male ; Middle Aged

Neuroendocrine tumors of the extrahepatic biliary tree are extremely rare malignancies accounting for 0.2-2.0% of all gastrointestinal carcinoid tumors. Neuroendocrine tumors obstructing the biliary tree are extremely difficult to diagnose preoperatively and nearly impossible to differentiate from cholangiocarcinoma. Statistically, the most common anatomic location in the biliary tree is the common bile duct, followed by the perihilar region. Herein, we present a case of a small cell neuroendocrine carcinoma of the hilum in a 79-year-old man following laparotomy. To our knowledge, this is the first case of small cell type neuroendocrine carcinoma of hilar bile duct reported in Korea.
Aged ; Bile Duct Neoplasms/*diagnosis/pathology/surgery ; Cholangiopancreatography, Endoscopic Retrograde ; Diagnosis, Differential ; Hepatic Duct, Common/pathology ; Humans ; Male ; Neuroendocrine Tumors/*diagnosis/pathology/surgery ; Tomography, X-Ray Computed

OBJECTIVETo summarize the clinical experience with diagnosis and treatment of intrahepatic biliary cystadenoma (IBCA).

METHODSWe retrospectively analyzed the data of 10 consecutive IBCA cases treated in our department in light of the characteristics of the epidemiology, radiology, lab tests, pathology and prognostic.

RESULTSThe patients are all female with an average age of 48.9 (16-73) years. The number of asymptomatic, slightly symptomatic and severe symptomatic patients was 4, 4 and 2, respectively. Radiological examination showed segmented cystic lesions in all the cases with an average diameter is 13.3∓4.9 cm. The incidence of segmentation, papillary or nodular hyperplasia, and calcification within the lesions was 90%, 60% and 20%, respectively. Macroscopic examination of the specimen showed compartmentation in the lesions, and microscopically, the lesions all showed lining of cubic or columnar epithelium on the inner wall with ovary-like or fibrous stroma. Complete resection of the tumor was achieved in 8 cases and partial resection was performed in 2 cases. The patients were followed up for a mean of 55.3 (12-164) months, and none of the patients with complete tumor resection showed recurrence, while both of the two patients with partial resection had postoperative recurrence.

CONCLUSIONIBCA is a rare cystic lesion occurring primarily in middle-aged women. The preoperative diagnosis of this disease relies primarily on radiological evidences, and a complete resection of IBCA may prolong the patient survival.

Adolescent ; Adult ; Aged ; Bile Duct Neoplasms ; diagnosis ; pathology ; surgery ; Bile Ducts, Intrahepatic ; pathology ; surgery ; Cystadenoma ; diagnosis ; pathology ; surgery ; Female ; Humans ; Middle Aged ; Retrospective Studies ; Sex Factors ; Young Adult