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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
Article

Abstract

Background

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.

Methods

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

Results

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).

Conclusions

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.

Keywords

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.

Notes

Acknowledgment

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.

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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

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