World Journal of Surgery

, Volume 37, Issue 2, pp 437–442 | Cite as

Catheter Tract Recurrence After Percutaneous Biliary Drainage for Hilar Cholangiocarcinoma

  • Mee Joo Kang
  • Yun-Suk Choi
  • Jin-Young Jang
  • In Woong Han
  • Sun-Whe KimEmail author



Despite its wide use, catheter tract recurrence after percutaneous biliary drainage (PBD) is rarely reported. However, one recent large-scale study reported a catheter tract recurrence rate as high as 5.2 % in patients with perihilar or distal bile duct cancer. We report on our 20 years of experience with catheter tract seeding after PBD for hilar cholangiocarcinoma.


The medical records of 441 patients who underwent operation for hilar cholangiocarcinoma between 1991 and 2011 were retrospectively analyzed.


Of the 441 patients with hilar cholangiocarcinoma, PBD was performed in 315 patients, and 232 others underwent resection of hilar cholangiocarcinoma with PBD. Catheter tract recurrence developed in 6 patients (2.6 %). The median drainage duration was 30 days, and 1 patient had multiple PBDs. The median time to catheter recurrence after surgery was 10.9 months. Three patients underwent curative resection of the abdominal wall followed by chemotherapy, 1 patient underwent chemotherapy only, and 2 patients received conservative treatment. Five patients in whom the catheter tract recurrence was their first recurrence died of systemic recurrence at median 3.9 months after detection of catheter tract seeding. T1 or 2 disease (66.7 vs. 31.3 %; p = 0.086) tended to have catheter tract seeding with marginal significance. The overall survival rate was lower in patients with catheter tract seeding than in those without (median 17.5 vs. 23.0 months; p = 0.089).


The PBD catheter tract recurrence rate for hilar cholangiocarcinoma was 2.6 %. However, patients with catheter tract recurrence had a poor prognosis despite complete surgical metastasectomy.


Biliary Drainage Hilar Cholangiocarcinoma Bile Duct Cancer Endoscopic Biliary Drainage Chest Wall Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.



This study was supported by a grant from Seoul National University Hospital (No. 04-2011-1000).

Conflict of interest

The authors disclose no conflict of interest.


  1. 1.
    Chapman WC, Sharp KW, Weaver F et al (1989) Tumor seeding from percutaneous biliary catheters. Ann Surg 209:708–713PubMedCrossRefGoogle Scholar
  2. 2.
    Clouse ME, Evans D, Costello P et al (1983) Percutaneous transhepatic biliary drainage. Complications due to multiple duct obstructions. Ann Surg 198:25–29PubMedGoogle Scholar
  3. 3.
    Ferrucci JT Jr, Mueller PR, Harbin WP (1980) Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology 135:1–13PubMedGoogle Scholar
  4. 4.
    Hansson JA, Hoevels J, Simert G et al (1979) Clinical aspects of nonsurgical percutaneous transhepatic bile drainage in obstructive lesions of the extrahepatic bile ducts. Ann Surg 189:58–61PubMedCrossRefGoogle Scholar
  5. 5.
    McPherson GA, Benjamin IS, Habib NA et al (1982) Percutaneous transhepatic drainage in obstructive jaundice: advantages and problems. Br J Surg 69:261–264PubMedCrossRefGoogle Scholar
  6. 6.
    Nakayama T, Ikeda A, Okuda K (1978) Percutaneous transhepatic drainage of the biliary tract: technique and results in 104 cases. Gastroenterology 74:554–559PubMedGoogle Scholar
  7. 7.
    Sakata J, Shirai Y, Wakai T et al (2005) Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma. World J Gastroenterol 11:7024–7027PubMedGoogle Scholar
  8. 8.
    Oleaga JA, Ring EJ, Freiman DB et al (1980) Extension of neoplasm along the tract of a transhepatic tube. AJR Am J Roentgenol 135:841–842PubMedGoogle Scholar
  9. 9.
    Takahashi Y, Nagino M, Nishio H et al (2010) Percutaneous transhepatic biliary drainage catheter tract recurrence in cholangiocarcinoma. Br J Surg 97:1860–1866PubMedCrossRefGoogle Scholar
  10. 10.
    Gouma DJ, Wesdorp RI, Oostenbroek RJ et al (1983) Percutaneous transhepatic drainage and insertion of an endoprosthesis for obstructive jaundice. Am J Surg 145:763–768PubMedCrossRefGoogle Scholar
  11. 11.
    Okuda K, Tanikawa K, Emura T et al (1974) Nonsurgical, percutaneous transhepatic cholangiography–diagnostic significance in medical problems of the liver. Am J Dig Dis 19:21–36PubMedCrossRefGoogle Scholar
  12. 12.
    Gobien RP, Stanley JH, Soucek CD et al (1984) Routine preoperative biliary drainage: effect on management of obstructive jaundice. Radiology 152:353–356PubMedGoogle Scholar
  13. 13.
    Nimura Y, Kamiya J, Kondo S et al (1995) Technique of inserting multiple biliary drains and management. Hepatogastroenterology 42:323–331PubMedGoogle Scholar
  14. 14.
    Sano T, Nimura Y, Hayakawa N et al (1997) Partial hepatectomy for metastatic seeding complicating pancreatoduodenectomy. Hepatogastroenterology 44:263–267PubMedGoogle Scholar
  15. 15.
    Inagaki M, Yabuki H, Hashimoto M et al (1999) Metastatic seeding of bile duct carcinoma in the transhepatic catheter tract: report of a case. Surg Today 29:1260–1263PubMedCrossRefGoogle Scholar
  16. 16.
    Mizuno T, Ishizaki Y, Komuro Y et al (2007) Surgical treatment of abdominal wall tumor seeding after percutaneous transhepatic biliary drainage. Am J Surg 193:511–513PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2012

Authors and Affiliations

  • Mee Joo Kang
    • 1
  • Yun-Suk Choi
    • 1
  • Jin-Young Jang
    • 1
  • In Woong Han
    • 1
  • Sun-Whe Kim
    • 1
    Email author
  1. 1.Department of Surgery and Cancer Research InstituteSeoul National University College of MedicineSeoulSouth Korea

Personalised recommendations