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Cholangiography of mucin‐hypersecreting intrahepatic biliary neoplasms
Author(s) -
Jan YiYin,
Chen MiinFu,
Hung ChienFu
Publication year - 1997
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02489785
Subject(s) - medicine , cholangiography , radiology , biliary tract , bile duct , common bile duct , duct (anatomy) , intrahepatic bile ducts , gastroenterology , pathology
Bile duct obstruction caused by profuse mucin secretion in a major bile duct is rare. Such cases are often incorrectly identified as choledocholithiasis before being histologically proven. The goal of this study was to analyze the cholangiograms of mucin‐hypersecreting intrahepatic biliary neoplasms and to try to identify the characteristic cholangiographic features of this rare disease. A retrospective analysis of 20 cholangiograms (from 6 men and 14 women) of mucin‐hypersecreting intrahepatic biliary neoplasms over a 13‐year period was carried out. Sixty percent of the patients had associated biliary tract stones. A mucinous substance drained out during biliary catheterization (endoscopic retrograde cholangiography [ERC]; percutaneous transhepatic cholangiography [PTC] in 4 patients. The cholangiographic findings included: (1) The appearance of diffuse “ground‐glass” filling defects of extrahepatic duct and non‐visualization of the tumor‐bearing intrahepatic duct in 9 patients (45%), (2) multiple amorphous filling defects of the extrahepatic duct and tumor‐bearing intrahepatic duct in 5 patients (25%), (3) multiple filling defects of the extrahepatic duct and non‐visualization of the tumor‐bearing intrahepatic duct in 4 patients (20%), and (4) single amorphous filling defect of the extrahepatic duct in 2 patients (10%). Mucin‐hypersecreting intrahepatic tumors with mucobilia should be highly suspected when the following cholangiographic characteristic are shown: (1) mucinous substance draining out during catheterization (ERC or PTC); (2) diffuse “ground‐glass” appearance filling defects; and (3) multiple amorphous filling defects of the bile duct associated with a cystic mass density within the liver on sonography or computed tomographic scan.