Hepatholithiasis-Associated Cholangiocarcinoma

Her, Kuy Hee; Kim, Sun Whe; Suh, Kyung Suk; Lee, Kuhn Uk; Park, Yong Hyun

Abstract

BACKGROUND: Chronic biliary-tract infection and long-standing hepatolithiasis are considered as important etiologic factors of a cholangiocarcinoma. PURPOSE: We reviewed cases of hepatolithiasis-associated cholangiocarcinomas to determine their clinical and pathologic characteristics.
RESULTS
Nineteen patients with heptolithiasis-associated cholangiocarcinomas admitted during the last 6 years. The incidence of cholangiocarcinomas among the patients with hepatholithiasis was 8.5% (19/224). Their mean age was 59.4 years, which was older than that of the hepatolithiasis patients (53 years). The dominant location of the stones was the left lobe, followed by both lobes and the right lobe. In two cases, the stones were found in different locations from the cancer. The interval between the diagnosis of stones and the diagnosis of cancer was five months to 12 years. A hepatic resection was performed in 8 cases of them. A follow-up study was performed in sixteen cases. Two of seven patients with a curative resection died:one at eight months and the other at thirty-one months post operatively. Five patients are still surviing without recurrence. All nine patients in the non-resected group died during the follow-up period. The overall median survival was 9 month.
CONCLUSION
Hepatolithiasis is one of the important causative factors of cholangiocarcinomas, The possibility of an associated cholangiocarcinoma should be considered in the patients with hepatolithiasis before and after the surgery, and even after the stones have been eradicated. Hence, life long close observation is essential for hepatolithiasis patients.