A RESECTED CASE OF INTRAMUCOSAL HILAR CHOLANGIOCARCINOMA

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  • MUN Yumi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • TODOROKI Takeshi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • KAWAMOTO Toru
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • YOSHIDA Sadao
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • KOIKE Naoto
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • FUKUNAGA Kiyoshi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • KONDO Tadashi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • MONOI Hisashi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • YUZAWA Kenji
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • OTSUKA Masaaki
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine
  • FUKAO Katashi
    Department of Gastrointestinal Surgery, The University of Tsukuba, School of Medicine

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Other Title
  • 粘膜内肝門部胆管癌の1切除例

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Abstract

We experienced a radical operation for a hilar cholangiocarcinoma localized in the mucosa.<br> A 61-year-old woman was seen at the hospital because of a right hypochondralgia. On blood biochemical examination only mild increases in biliary enzymes and bilirubin value were noted. There was no jaundice. Abdominal ultrasonography visualized a dilation from the intrahepatic bile duct to common hepatic duct and an elevated lesion in the lumen. Further PTC and contrast enhanced CT revealed multiple papillary cholangiocarcinomas with the main lesion at the confluence f bilateral hepatic ducts. We determined that a radical treatment was possible by resection of the bile duct in the hepatic hilar region and combined resection of the caudate lobe. Histologically it was papillary adenocarcinoma with the invasion depth of m. There have been only three cases of early cholangiocarcinoma of the hepatic hilar region in Japan. This disease very rarely occurs. All three cases lacked in subjective symptoms and presented no jaundice. In the diagnosis of the disease abdominal ultrasonography was useful. Papilary cholangiocarcinomas are often multiple and minute preoperative diagnosis of intra and extra-hepatic bile duct is essential for the radical therapy.

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