Journal of Gastrointestinal Surgery

, Volume 17, Issue 4, pp 748–755 | Cite as

Prevalence of Nonalcoholic Steatohepatitis Among Patients with Resectable Intrahepatic Cholangiocarcinoma

  • Srinevas K. Reddy
  • Omar Hyder
  • J. Wallis Marsh
  • Georgios C. Sotiropoulos
  • Andreas Paul
  • Sorin Alexandrescu
  • Hugo Marques
  • Carlo Pulitano
  • Eduardo Barroso
  • Luca Aldrighetti
  • David A. Geller
  • Christine Sempoux
  • Vlad Herlea
  • Irinel Popescu
  • Robert Anders
  • Laura Rubbia-Brandt
  • Jean-Francois Gigot
  • Giles Mentha
  • Timothy M. PawlikEmail author
Original Article


Background and Aims

The objective of this report was to determine the prevalence of underlying nonalcoholic steatohepatitis in resectable intrahepatic cholangiocarcinoma.


Demographics, comorbidities, clinicopathologic characteristics, surgical treatments, and outcomes from patients who underwent resection of intrahepatic cholangiocarcinoma at one of eight hepatobiliary centers between 1991 and 2011 were reviewed.


Of 181 patients who underwent resection for intrahepatic cholangiocarcinoma, 31 (17.1 %) had underlying nonalcoholic steatohepatitis. Patients with nonalcoholic steatohepatitis were more likely obese (median body mass index, 30.0 vs. 26.0 kg/m2, p < 0.001) and had higher rates of diabetes mellitus (38.7 vs. 22.0 %, p = 0.05) and the metabolic syndrome (22.6 vs. 10.0 %, p = 0.05) compared with those without nonalcoholic steatohepatitis. Presence and severity of hepatic steatosis, lobular inflammation, and hepatocyte ballooning were more common among nonalcoholic steatohepatitis patients (all p < 0.001). Macrovascular (35.5 vs. 11.3 %, p = 0.01) and any vascular (48.4 vs. 26.7 %, p = 0.02) tumor invasion were more common among patients with nonalcoholic steatohepatitis. There were no differences in recurrence-free (median, 17.0 versus 19.4 months, p = 0.42) or overall (median, 31.5 versus 36.3 months, p = 0.97) survival after surgical resection between patients with and without nonalcoholic steatohepatitis.


Nonalcoholic steatohepatitis affects up to 20 % of patients with resectable intrahepatic cholangiocarcinoma.


Nonalcoholic fatty liver disease Nonalcoholic steatohepatitis Intrahepatic cholangiocarcinoma Nonalcoholic fatty liver disease activity score 



Nonalcoholic steatohepatitis


Intrahepatic cholangiocarcinoma


Body mass index


American Joint Committee on Cancer


Nonalcoholic fatty liver disease


Hepatocellular carcinoma


Nonalcoholic fatty liver disease activity score


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Copyright information

© The Society for Surgery of the Alimentary Tract 2013

Authors and Affiliations

  • Srinevas K. Reddy
    • 1
  • Omar Hyder
    • 2
  • J. Wallis Marsh
    • 3
  • Georgios C. Sotiropoulos
    • 4
  • Andreas Paul
    • 4
  • Sorin Alexandrescu
    • 5
  • Hugo Marques
    • 6
  • Carlo Pulitano
    • 7
  • Eduardo Barroso
    • 6
  • Luca Aldrighetti
    • 7
  • David A. Geller
    • 3
  • Christine Sempoux
    • 8
  • Vlad Herlea
    • 5
  • Irinel Popescu
    • 5
  • Robert Anders
    • 2
  • Laura Rubbia-Brandt
    • 9
  • Jean-Francois Gigot
    • 9
  • Giles Mentha
    • 9
  • Timothy M. Pawlik
    • 2
    Email author
  1. 1.Department of SurgeryUniversity of Maryland School of MedicineBaltimoreUSA
  2. 2.Department of SurgeryJohns Hopkins University School of MedicineBaltimoreUSA
  3. 3.Department of SurgeryUniversity of Pittsburgh Medical CenterPittsburghUSA
  4. 4.Department of SurgeryUniversity Hospital EssenEssenGermany
  5. 5.Dan Setlacec Center of General Surgery and Liver TransplantationFundeni Clinical InstituteBucharestRomania
  6. 6.Department of SurgeryCurry Cabral HospitalLisbonPortugal
  7. 7.Department of SurgeryOspedale San RaffaeleMilanItaly
  8. 8.Department of PathologyCliniques Universitaires Saint-LucBrusselsBelgium
  9. 9.Department of PathologyHopitaux Universitaires de GeneveGenevaSwitzerland

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