Surgical Treatment for Intrahepatic Cholangiocarcinoma

Kim, Eun Young; Yae, Byoung Kuk; Sim, Mun Sup

Abstract

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.