3.Cholangiocarcinoma arising in von Meyenburg complexes.
The Korean Journal of Hepatology 2011;17(2):161-164
5.A Case of Choledochoduodenal Fistula as a Delayed Complication after Biliary Metallic Stent Placement in Distal Cholangiocarcinoma.
Seol Kyung MOON ; Dae Young CHEUNG ; Ji Hun KIM ; Eun Joo IM ; Jick Hwan HA ; Jin Il KIM ; Soo Heon PARK ; Jae Kwang KIM
The Korean Journal of Gastroenterology 2008;51(5):314-318
Biliary drainage in patients with malignant biliary obstruction relieves jaundice and prevents the development of cholangitis or hepatic failure from biliary obstruction. Therefore, this may result in better quality of life along with survival prolongation. Biliary stent placement is an effective and safe measure for biliary decompression and is preferred than bypass surgery in high risk patients. Entero-biliary perforation-communication is one of the rare complications of biliary stent. We herein report a case of duodeno-biliary perforation-communication in patient with distal cholangiocarcinoma who presented with duodenal ulcer and obstruction, occurring 4 years later from the metallic biliary stent insertion. Patient was managed with a pyloric metal stent and conservative care.
Aged, 80 and over
;
Bile Duct Neoplasms/complications/*diagnosis
;
Bile Ducts, Intrahepatic/pathology
;
Biliary Fistula/*diagnosis/etiology/pathology
;
Cholangiocarcinoma/complications/*diagnosis
;
Duodenal Diseases/*diagnosis/etiology/pathology
;
Female
;
Humans
;
Intestinal Fistula/*diagnosis/etiology/pathology
;
Stents/*adverse effects
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Tomography, X-Ray Computed
6.Hepatoma presenting as extrahepatic biliary obstruction due to hemobilia.
Byoung Seon RHOE ; Hoguen KIM ; So Young JIN ; Woo Ick JANG
Yonsei Medical Journal 1989;30(4):383-386
A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
Bile Duct Obstruction, Extrahepatic/*etiology/pathology
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Biopsy
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Carcinoma, Hepatocellular/*complications/pathology/surgery
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Case Report
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Common Bile Duct/pathology
;
Female
;
Hemobilia/*complications
;
Human
;
Liver Cirrhosis/diagnosis
;
Liver Neoplasms
;
Middle Age
7.Hepatoma presenting as extrahepatic biliary obstruction due to hemobilia.
Byoung Seon RHOE ; Hoguen KIM ; So Young JIN ; Woo Ick JANG
Yonsei Medical Journal 1989;30(4):383-386
A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
Bile Duct Obstruction, Extrahepatic/*etiology/pathology
;
Biopsy
;
Carcinoma, Hepatocellular/*complications/pathology/surgery
;
Case Report
;
Common Bile Duct/pathology
;
Female
;
Hemobilia/*complications
;
Human
;
Liver Cirrhosis/diagnosis
;
Liver Neoplasms
;
Middle Age
8.Triple-Tissue Sampling during Endoscopic Retrograde Cholangiopancreatography Increases the Overall Diagnostic Sensitivity for Cholangiocarcinoma.
Seung June LEE ; Yoon Suk LEE ; Min Geun LEE ; Sang Hyub LEE ; Eun SHIN ; Jin Hyeok HWANG
Gut and Liver 2014;8(6):669-673
BACKGROUND/AIMS: There are several methods for obtaining tissue samples to diagnose malignant biliary strictures during endoscopic retrograde cholangiopancreatography (ERCP). However, each method has only limited sensitivity. This study aimed to evaluate the diagnostic accuracy of a combined triple-tissue sampling (TTS) method (on-site bile aspiration cytology, brush cytology, and forceps biopsy). METHODS: We retrospectively reviewed 168 patients with suspicious malignant biliary strictures who underwent double-tissue sampling (DTS; n=121) or TTS (n=47) via ERCP at our institution from 2004 to 2011. RESULTS: Among the 168 patients reviewed, 117 patients (69.6%) were eventually diagnosed with malignancies. The diagnostic sensitivity for cancer was significantly higher in the TTS group than the DTS group (85.0% vs 64.9%, respectively; p=0.022). Furthermore, the combination of brush cytology and forceps biopsy was superior to the other method combinations in the DTS group. With respect to cancer type (cholangiocarcinoma vs noncholangiocarcinoma), interestingly, the diagnostic sensitivity was higher for cholangiocarcinoma in the TTS group than the DTS group (100% vs 69.4%, respectively; p<0.001) but not for the non-cholangiocarcinoma patients (57.1% vs 57.1%, respectively). CONCLUSIONS: TTS can provide an improved diagnostic accuracy in suspicious malignant biliary strictures, particularly for cholangiocarcinoma.
Aged
;
Ampulla of Vater/*pathology
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Bile Duct Neoplasms/complications/diagnosis/pathology
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Bile Ducts, Intrahepatic/*pathology
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Biopsy/*methods
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Biopsy, Needle
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Carcinoma/complications/diagnosis/pathology
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Cholangiocarcinoma/complications/*diagnosis/pathology
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Cholangiopancreatography, Endoscopic Retrograde/*methods
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Cholestasis/etiology
;
Common Bile Duct Neoplasms/complications/*diagnosis/pathology
;
Female
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Humans
;
Male
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Middle Aged
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Pancreatic Neoplasms/complications/*diagnosis/pathology
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Retrospective Studies
;
Sensitivity and Specificity
9.A Case of Intrahepatic Cholangiocarcinoma Associated with Type IV Choledochal Cyst.
Suk Hun KIM ; Hyung Wook KIM ; Dae Hwan KANG ; Min Dae KIM ; Jin Ho LEE ; Jae Hyung LEE ; Bong Gap KIM ; Jong Hwan PARK
The Korean Journal of Gastroenterology 2012;60(2):123-127
Anomalous union of the pancreaticobiliary duct (AUPBD) is a congenital anomaly that is defined as a junction of the bile duct and pancreatic duct outside the duodenal wall. This anomaly results in a loss of normal sphincteric mechanisms at the pancreaticobiliary junction. As a result, regurgitation of pancreatic juice into the biliary system develops and causes choledochal cysts, choledocholithiasis, cholangitis, pancreatitis and malignancy of the biliary tract. Gallbladder cancer or common bile duct cancer associated with AUPBD and choledochal cysts have been frequently reported. But, intrahepatic cholangiocarcinoma associated with this condition has been only rarely reported. Here, we report a case of intrahepatic cholangiocarcinoma associated with AUPBD and choledochal cyst.
Adult
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Bile Duct Neoplasms/*diagnosis/etiology/pathology
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*Bile Ducts, Intrahepatic
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Cholangiocarcinoma/*diagnosis/etiology/pathology
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Cholangiopancreatography, Endoscopic Retrograde
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Cholangiopancreatography, Magnetic Resonance
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Choledochal Cyst/complications/*diagnosis
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Female
;
Humans
;
Positron-Emission Tomography and Computed Tomography
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Tomography, X-Ray Computed
10.Clinical value of "Kou mode of hepatic hilar anastomosis" in resection of type III or IV hepatic hilar cholangiocarcinoma.
Xiao-dong HE ; Wei LIU ; Lian-yuan TAO ; Zhen-huan ZHANG ; Lei CAI ; Shuang-min ZHANG
Chinese Journal of Oncology 2009;31(8):626-629
OBJECTIVETo evaluate the surgical technique of "Kou mode of hepatic hilar anastomosis" in the treatment for type III or IV hilar cholangiocarcinoma.
METHODSThe clinical data of 89 patients with type III or IV hilar cholangiocarcinoma surgically treated in our department between Jan. 1990 and Jan. 2008 were retrospectively analyzed. Since January 2000, "Kou mode of hepatic hilar anastomosis" was performed for some patients with advanced hilar cholangiocarcinoma. The patients were divided into two groups: group A treated between 1990 and 1999, group B between 2000 and 2008. The rate of resection, therapeutic efficacy and complications in these two groups were compared, respectively.
RESULTSOf the 37 cases with hilar cholangiocarcinoma in group A, 4 were surgically treated (10.8%), with 1 (2.7%) radical resection and 3 (8.1%) palliative resection. Among the 52 cases with hilar cholangiocarcinoma in the group B, 35 (67.3%) received surgical resection, of them 15 (28.8%) underwent radical resection and 20 (38.5%) had palliative resection. Twenty-eight of these 35 cases underwent the "Kou mode of hepatic hilar anastomosis". The resection rate of advanced hilar cholangiocarcinoma in the group B was significantly higher than that in group A (P < 0.05). The complications in the 89 cases included ascites (3 cases), hemobilia (1 case), heart failure (1 case), and wound infection (2 cases). All the patients who were treated with the "Kou mode of hepatic hilar anastomosis" developed bile leakage to a varying degree and recovered after drainage and symptomatic treatment.
CONCLUSIONThe resection rate of type III or IV advanced hilar cholangiocarcinoma can be remarkably improved by using a novel alternative surgical technique called "Kou mode of hepatic hilar anastomosis". However, the long-term outcome still needs to be determined by close follow-up and further observation.
Aged ; Anastomosis, Surgical ; adverse effects ; methods ; Ascites ; etiology ; Bile Duct Neoplasms ; pathology ; surgery ; Bile Ducts, Intrahepatic ; surgery ; Cholangiocarcinoma ; pathology ; surgery ; Female ; Hemobilia ; etiology ; Hepatectomy ; adverse effects ; methods ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies