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A reappraisal of cholangiocarcinoma in patient with hepatolithiasis
Author(s) -
Chen MiinFu,
Jan YiYin,
Wang ChiaSiu,
Hwang TsannLong,
Jeng LongBing,
Chen ShinCheh,
Chen TongJong
Publication year - 1993
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19930415)71:8<2461::aid-cncr2820710806>3.0.co;2-7
Subject(s) - hepatolithiasis , medicine , hepatectomy , laparotomy , incidence (geometry) , bile duct , gastroenterology , surgery , resection , physics , optics
Background . Hepatolithiasis associated with cholangiocarcinoma is not often encountered. During the past 3 years, an increased incidence of patients with hepatolithiasis associated with cholangiocarcinoma was noted. Data were needed to reliably determine the incidence of this disease. Methods . Data concerning the relationship between cholangiocarcinoma and hepatolithiasis are presented. The treatment modalities and factors that influence long‐term survival are discussed. Results . The overall incidence of cholangiocarcinoma in association with hepatolithiasis was 5.0% (55 in 1105). Before 1987, 65% of cholangiocarcinoma in association with hepatolithiasis was diagnosed postoperatively. After 1987, the incidence of accurate preoperative diagnosis increased (22.8%), and in most of the other instances (62.8%), the diagnosis was made at laparotomy. Surgical procedures consisted of common bile duct exploration with T‐tube drainage (100%) and hepatectomy (38.2%). Mortality for patients who underwent surgery was 5.4%; they died of recurrent cholangitis. The overall median survival time of patients with cholangiocarcinoma in association with hepatolithiasis was 10.4 months; the 1‐, 2‐, and 4‐year cumulative survival rates were 30.0%, 12.7%, and 3.6%, respectively. Patients with hepatectomy or the presence of mucobilia had better survival rates ( P < 0.05). Conclusions . The overall incidence of hepatolithiasis associated with cholangiocarcinoma was 5%. In most patients with cholangiocarcinoma in association with hepatolithiasis, diagnosis can be made preoperatively and at laparotomy. Patients with hepatectomy or presence of mucobilia had better survival rates.