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KMID : 0870420020060010006
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2002 Volume.6 No. 1 p.6 ~ p.11
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Surgical Treatment for Intrahepatic Cholangiocarcinoma
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Kim Eun-Young
Yea Byung-Kook
Sim Mun-Sup
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Abstract
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Background/Aims: Intrahepatic cholangiocarcinoma, which has been defined as a primary adenocarcinoma from the intrahepatic bile ducts distal to the second-order branch of the main hepatic ducts, has a poor prognosis against various treatment modalities. We analyzed the clinical characteristics of intrahepatic cholangiocarcinomas and evaluated the outcomes of surgical treatment.
Methods: Forty five cases of microscopically-proven intrahepatic cholangiocarcinoma during 8 and a half year period from January 1993 to june 2001 were reviewed.
Results: They comprised 29 men and 16 women with an average age of 54.3 years (range: 34 to 76 years). The overall incidence of intrahepatic cholangiocarcinoma in association with hepatolithiasis was 4~% and in this sutdy 17 out of 45 cases (37.8%) of intrahepatic cholangiocarcinoma was combined with intrahepatic stones. The incidence of accurate preoperative diagnosis was 56% due to low index of suspicion. The growth pattern of intrahepatic cholangiocarcinoma was mass-forming type in 32 cases, periductal infiltrative type in 9 cases, and intraductal growth type in 4 cases.
Conclusion: Careful preoperative evaluation using computed tomography, ultrasonography, and angiography and a study of tumor markers for the possibility of a intrahepatic cholangiocarcinoma is necessary in risk groups with hepatolithiasis or clonorchiasis. Hepatric resection should be used in hepatolithiasis patients to improve the chance of survival.
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KEYWORD
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Intraheptic cholangiocarcinoma
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