Limits...
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

Macroscopic and histological findings. a Macroscopically, the mass invades the duodenum, jejunum, and pancreatic head. b Histological examination reveals a moderately differentiated adenocarcinoma. PV portal vein, Ph pancreatic head
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC4764596&req=5

Fig7: Macroscopic and histological findings. a Macroscopically, the mass invades the duodenum, jejunum, and pancreatic head. b Histological examination reveals a moderately differentiated adenocarcinoma. PV portal vein, Ph pancreatic head

Mentions: The patient developed postoperative sepsis and a grade B (International Study Group of Pancreatic Surgery) pancreatic fistula. Both of these complications resolved through conservative therapy. The flow from the subphrenic artery to the remnant liver was confirmed on postoperative day 3, whereas the arterioportal anastomosis was spontaneously obstructed by postoperative day 24. Macroscopically, the mass at the hepatic hilum invaded the duodenum, jejunum, and pancreatic head (Fig. 7a). Histological examination revealed a moderately differentiated adenocarcinoma with infiltration of the pancreatic head, jejunum, and wall of the PV (Fig. 7b). The hepatic artery was surrounded by tumor cells. Thus, a diagnosis of cholangiocarcinoma recurrence was made. The patient was discharged on postoperative day 46 in good health.Fig. 7


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)

Macroscopic and histological findings. a Macroscopically, the mass invades the duodenum, jejunum, and pancreatic head. b Histological examination reveals a moderately differentiated adenocarcinoma. PV portal vein, Ph pancreatic head
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig7: Macroscopic and histological findings. a Macroscopically, the mass invades the duodenum, jejunum, and pancreatic head. b Histological examination reveals a moderately differentiated adenocarcinoma. PV portal vein, Ph pancreatic head
Mentions: The patient developed postoperative sepsis and a grade B (International Study Group of Pancreatic Surgery) pancreatic fistula. Both of these complications resolved through conservative therapy. The flow from the subphrenic artery to the remnant liver was confirmed on postoperative day 3, whereas the arterioportal anastomosis was spontaneously obstructed by postoperative day 24. Macroscopically, the mass at the hepatic hilum invaded the duodenum, jejunum, and pancreatic head (Fig. 7a). Histological examination revealed a moderately differentiated adenocarcinoma with infiltration of the pancreatic head, jejunum, and wall of the PV (Fig. 7b). The hepatic artery was surrounded by tumor cells. Thus, a diagnosis of cholangiocarcinoma recurrence was made. The patient was discharged on postoperative day 46 in good health.Fig. 7

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