Abstract
Introduction
Cholangiocellular carcinoma accounts for 3% of gastrointestinal tumors. It is the second most common primary hepatic malignancy and is associated with primary sclerosing cholangitis.
Case description
We report a patient with primary sclerosing cholangitis and cholangiocellular carcinoma who underwent partial hepatectomy and postoperatively suffered life-threatening biliary stasis with cholascos and peritonitis. The patient had cholangiocellular carcinoma recurrence at the resection margins and local lymph node metastases, but chemotherapy was not possible because of elevated bilirubin and liver dysfunction. After successful percutaneous stenting and placement of an internal–external drainage tube from the biliary tree to the gastric ventricle, ascites and cholascos resolved completely and the patient was then referred for chemotherapy. The internal–external drainage tube was converted to an internal tube after 3 1/2 months. The patient received chemotherapy and survived 14 months after stenting.
Discussion
Preferably, bile leaks should be detected preoperatively but the ongoing development of solutions to the postoperative biliary complications seen in these patients is extremely important.
Abbreviations
- CLC:
-
Cholangiocellular carcinoma
- PSC:
-
Primary sclerosing cholangitis
- MRI:
-
Magnetic resonance imaging
- ERCP:
-
Endoscopic retrograde cholangiopancreatography
- PET:
-
Positron emission tomography
- PTC:
-
Percutaneus transhepatic cholangiography
- OLT:
-
Orthotopic liver transplantation
References
Blechacz BR, Gores GJ. Cholangiocarcinoma. Clin Liver Dis. 2008;12:131–50. ix.
Tajiri T, Yoshida H, Mamada Y, Taniai N, Yokomuro S, Mizuguchi Y. Diagnosis and initial management of cholangiocarcinoma with obstructive jaundice. World J Gastroenterol. 2008;14:3000–5.
Vigano L, Ferrero A, Sgotto E, Tesoriere RL, Calgaro M, Capussotti L. Bile leak after hepatectomy: predictive factors of spontaneous healing. Am J Surg. 2008;196:195–200.
Reed Jr DN, Vitale GC, Wrightson WR, Edwards M, McMasters K. Decreasing mortality of bile leaks after elective hepatic surgery. Am J Surg. 2003;185:316–8.
Bhattacharjya S, Puleston J, Davidson BR, Dooley JS. Outcome of early endoscopic biliary drainage in the management of bile leaks after hepatic resection. Gastrointest Endosc. 2003;57:526–30.
Massoumi H, Kiyici N, Hertan H. Bile leak after laparoscopic cholecystectomy. J Clin Gastroenterol. 2007;41:301–5.
Murakami Y, Uemura K, Sudo T, Hayashidani Y, Hashimoto Y, Nakamura H, et al. Gemcitabine-based adjuvant chemotherapy improves survival after aggressive surgery for hilar cholangiocarcinoma. J Gastrointest Surg. 2009;13:1470–9.
Ustundag Y, Bayraktar Y. Cholangiocarcinoma: a compact review of the literature. World J Gastroenterol. 2008;14:6458–66.
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Lauridsen, M.E.M., Mortensen, F.V., Nielsen, D.T. et al. Creation of a Fistula Between the Hepatic Duct and the Gastric Lumen by way of Percutaneus Transhepatic Cholangiography: A Case Report. J Gastrointest Canc 43, 354–357 (2012). https://doi.org/10.1007/s12029-010-9212-6
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DOI: https://doi.org/10.1007/s12029-010-9212-6