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Hepatopancreatoduodenectomy for local recurrence of cholangiocarcinoma after excision of a type IV-A congenital choledochal cyst: a case report.

Yamada M, Ebata T, Sugawara G, Igami T, Mizuno T, Shingu Y, Nagino M - Surg Case Rep (2016)

Bottom Line: There are limited data regarding the effectiveness of surgical resection for recurrent BTC.The patient, a 25-year-old woman, had undergone excision of a type IV-A congenital choledochal cyst with hepaticojejunostomy.The resected specimen revealed an early cholangiocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. m-yamada33@med.nagoya-u.ac.jp.

ABSTRACT
Surgical resection is the only curative treatment for biliary tract cancer (BTC); however, the recurrence rate remains high even after curative resection. There are limited data regarding the effectiveness of surgical resection for recurrent BTC. We report the favorable survival outcome of a patient who underwent a hepatopancreatoduodenectomy for local recurrence of cholangiocarcinoma after excision of a type IV-A congenital choledochal cyst. The patient, a 25-year-old woman, had undergone excision of a type IV-A congenital choledochal cyst with hepaticojejunostomy. The resected specimen revealed an early cholangiocarcinoma. The local recurrence at the site of anastomosis was detected 4 years and 4 months after surgery. We performed a left trisectionectomy with caudate lobectomy combined with hepatic artery and portal vein resections and a pancreaticoduodenectomy. Histological examination revealed a moderately differentiated adenocarcinoma, and the final diagnosis was recurrence of cholangiocarcinoma. There are a few reports of extensive resection for recurrence of BTC; however, aggressive surgery is possible and may offer favorable survival in selected patients.

No MeSH data available.


Related in: MedlinePlus

Portography. a Portal vein stenosis (a red arrow) with collateral veins from the left gastric vein are shown (dotted black arrows). b After performing a portal vein stenting and left portal vein embolization, the portal vein stenosis was resolved. LGV left gastric vein, RAPV right anterior portal vein, RPPV right posterior portal vein, LPV left portal vein, asterisk metallic stent placed in the portal vein
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Fig2: Portography. a Portal vein stenosis (a red arrow) with collateral veins from the left gastric vein are shown (dotted black arrows). b After performing a portal vein stenting and left portal vein embolization, the portal vein stenosis was resolved. LGV left gastric vein, RAPV right anterior portal vein, RPPV right posterior portal vein, LPV left portal vein, asterisk metallic stent placed in the portal vein

Mentions: CT revealed a mass over the pancreatic head from the hepatic hilum with an unclear and irregular border invading the duodenum and pancreatic head (Fig. 1). The mass invaded from the main PV to the bifurcation of the right anterior and posterior PV. The main PV was severely strictured (Fig. 2a). The common hepatic artery, gastroduodenal artery, and right and left hepatic arteries were also involved by the mass.Fig. 1


Hepatopancreatoduodenectomy for local recurrence of cholangiocarcinoma after excision of a type IV-A congenital choledochal cyst: a case report.

Yamada M, Ebata T, Sugawara G, Igami T, Mizuno T, Shingu Y, Nagino M - Surg Case Rep (2016)

Portography. a Portal vein stenosis (a red arrow) with collateral veins from the left gastric vein are shown (dotted black arrows). b After performing a portal vein stenting and left portal vein embolization, the portal vein stenosis was resolved. LGV left gastric vein, RAPV right anterior portal vein, RPPV right posterior portal vein, LPV left portal vein, asterisk metallic stent placed in the portal vein
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4764596&req=5

Fig2: Portography. a Portal vein stenosis (a red arrow) with collateral veins from the left gastric vein are shown (dotted black arrows). b After performing a portal vein stenting and left portal vein embolization, the portal vein stenosis was resolved. LGV left gastric vein, RAPV right anterior portal vein, RPPV right posterior portal vein, LPV left portal vein, asterisk metallic stent placed in the portal vein
Mentions: CT revealed a mass over the pancreatic head from the hepatic hilum with an unclear and irregular border invading the duodenum and pancreatic head (Fig. 1). The mass invaded from the main PV to the bifurcation of the right anterior and posterior PV. The main PV was severely strictured (Fig. 2a). The common hepatic artery, gastroduodenal artery, and right and left hepatic arteries were also involved by the mass.Fig. 1

Bottom Line: There are limited data regarding the effectiveness of surgical resection for recurrent BTC.The patient, a 25-year-old woman, had undergone excision of a type IV-A congenital choledochal cyst with hepaticojejunostomy.The resected specimen revealed an early cholangiocarcinoma.

View Article: PubMed Central - PubMed

Affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan. m-yamada33@med.nagoya-u.ac.jp.

ABSTRACT
Surgical resection is the only curative treatment for biliary tract cancer (BTC); however, the recurrence rate remains high even after curative resection. There are limited data regarding the effectiveness of surgical resection for recurrent BTC. We report the favorable survival outcome of a patient who underwent a hepatopancreatoduodenectomy for local recurrence of cholangiocarcinoma after excision of a type IV-A congenital choledochal cyst. The patient, a 25-year-old woman, had undergone excision of a type IV-A congenital choledochal cyst with hepaticojejunostomy. The resected specimen revealed an early cholangiocarcinoma. The local recurrence at the site of anastomosis was detected 4 years and 4 months after surgery. We performed a left trisectionectomy with caudate lobectomy combined with hepatic artery and portal vein resections and a pancreaticoduodenectomy. Histological examination revealed a moderately differentiated adenocarcinoma, and the final diagnosis was recurrence of cholangiocarcinoma. There are a few reports of extensive resection for recurrence of BTC; however, aggressive surgery is possible and may offer favorable survival in selected patients.

No MeSH data available.


Related in: MedlinePlus