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Priya D Farooq, Darryn R Potosky
We present the case of a patient who presented with signs and symptoms associated with a Klatskin tumor. After endoscopic retrograde cholangiopancreatography (ERCP) and biopsy, she was found instead to have granulomatous infiltration of the extrahepatic biliary tree consistent with biliary sarcoidosis. The patient was treated successfully with systemic corticosteroids and azathioprine. She later developed cutaneous, lymphatic, and pulmonary granulomatous disease. Isolated biliary disease is a rare initial presentation of systemic sarcoidosis...
August 2016: ACG Case Reports Journal
O I Okhotnikov, M V Yakovleva, V I Pakhomov
AIM: to analyze the efficacy of interventional methods in treatment of Klatskin tumor patients. MATERIAL AND METHODS: Treatment of 133 patients with Klatskin tumor for the period 2000-2015 was analyzed. Bismuth I type was revealed in 28 (21.1%) cases, type II  - in 45 (33.8%) cases, type III - in 51 (38.3%) cases, type IV - in 9 (6.8%) cases. All patients underwent sonofluoroscopy-assisted percutaneous transhepatic cholangiostomy using self-fixing Pig tail 8Fr drains at the first stage followed by externointernal drainage or antegrade biliary stenting...
2016: Khirurgiia
Jiao Dechao, Xinwei Han, Wang Yanli, Li Zhen
We report a case in an inoperable patient with type IV Klatskin tumor treated by the use of a novel, two piece, Y-configured self-expandable metallic stent (SEMS) combined with two (125)I seed strands via bilateral approach. The placement of the Y-shaped SEMS was successful and resulted in adequate biliary drainage. After 2 months of intraluminal brachytherapy (ILBT), both (125)I seed strands and temporary drainage catheter were removed after patency of the expanded stents was confirmed by the cholangiogram...
August 2016: Journal of Contemporary Brachytherapy
Kyong Joo Lee, Seung Woo Yi, Jihye Cha, Jinsil Seong, Seungmin Bang, Si Young Song, Hee Man Kim, Seung Woo Park
PURPOSE: Combination chemotherapy with gemcitabine and cisplatin is a standard treatment for patients with advanced biliary tract cancer. This study aimed to evaluate the efficacy and safety of gemcitabine- and cisplatin-based concurrent chemoradiotherapy in patients with unresectable biliary tract cancer. METHODS: Patients with pathologically proven, unresectable, non-metastatic biliary tract cancer were enrolled. Gemcitabine was administered intravenously at a dose of 1000 mg/m(2) on days 1, 8, and 15...
October 2016: Cancer Chemotherapy and Pharmacology
Yu O Zharikov, Yu A Kovalenko, A V Czhao
No abstract text is available yet for this article.
2016: Khirurgiia
Cengiz Özdemir, Sinem Nedime Sökücü, Ayşegül Akbaş, Sezin Altay, Ahmet Levent Karasulu, Levent Dalar
Bronchobiliary fistula (BBF) is a rare condition in which an abnormal communication exists between the bile ducts and the bronchial tree. Malignancy is the most common etiology of BBF, although many others are possible. A 74-year-old male patient with an inoperable Klatskin tumor presented with a complaint of yellow-green sputum and cough; the patient underwent fiber-optic bronchoscopy based on a preliminary diagnosis of bronchobiliary fistula. Using fiber-optic rigid bronchoscopy, the laterobasal segment of the lower right lung lobe was occluded using three pieces of 5-mm Endobronchial Watanabe Spigot...
2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Z Lu, D D Wang
Hilar cholangiocarcinoma (HCCA) is also known as cancer at the upper part of bile duct, perihilar cholangiocarcinoma or Klatskin tumor, etc.Bismuth-Corlette type Ⅲ hilar cholangiocarcinoma refers to tumor invading right hepatic duct (Ⅲa) or left hepatic duct (Ⅲb). While Bismuth-Corlette type Ⅳ hilar cholangiocarcinoma refers to both left and right intrahepatic bile ducts being invaded. Under the premise of strictly grasping the indications of surgery, if preoperative management is conducted carefully, extended hepatic resection is a safe and feasible surgery to remove Bismuth-Corlette type Ⅲ and type Ⅳ hilar cholangiocarcinoma...
July 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Casey M Luckhurst, Chelsey Perez, Amy L Collinsworth, Jose G Trevino
Classically, hepatic artery pseudoaneurysms (HAPs) arise secondary to trauma or iatrogenic causes. With an increasing prevalence of laparoscopic procedures of the hepatobiliary system the risk of inadvertent injury to arterial vessels is increased. Pseudoaneurysm formation post injury can lead to serious consequences of rupture and subsequent hemorrhage, therefore intervention in all identified visceral pseudoaneurysms has been advocated. A variety of interventional methods have been proposed, with surgical management becoming the last step intervention when minimally invasive therapies have failed...
June 28, 2016: World Journal of Hepatology
Jung Hyun Jo, Moon Jae Chung, Dai Hoon Han, Jeong Youp Park, Seungmin Bang, Seung Woo Park, Si Young Song, Jae Bock Chung
: Operative treatment combined with PBD has been established as a safe management strategy for Klatskin tumors. However, controversy exists regarding the preferred technique for PBD among percutaneous transhepatic biliary drainage (PTBD), endoscopic biliary stenting (EBS), and endoscopic nasobiliary drainage (ENBD). This study aimed to identify the best technique for preoperative biliary drainage (PBD) in Klatskin tumor patients. METHODS: This study evaluated 98 Klatskin tumor patients who underwent PBD prior to operation with a curative aim between 2005 and 2012...
June 10, 2016: Surgical Endoscopy
Uwe Scheuermann, Rizky Widyaningsih, Maria Hoppe-Lotichius, Michael Heise, Gerd Otto
INTRODUCTION: The aim of this study was to identify clinical, laboratory and radiological parameters to distinguish benign from malignant stenoses of the proximal bile duct. METHODS: Between 1997 and 2011, 250 patients were referred to our clinic with hilar bile duct stenoses suspicious for Klatskin tumour. Medical histories, clinical data, pre-interventional laboratory tests, imaging findings, as well as therapeutic approach and patient outcome were compared to final histological results...
June 2016: Annals of Medicine and Surgery
Shailesh Puntambekar, Vikrant Sharma, Sanjay Kumar, Sainath Mitkare, Geetanjali Joshi, Hirav Parikh
The only option for cure of Klatskin's tumour is surgical excision. The radicality of the procedure is determined by the extent of the tumour and functional parameters of the patient. Complete laparoscopic resection of hilar cholangiocarcinoma with biliary reconstruction is a challenging procedure. The main aim is to achieve pathological negative margins, complete lymph node retrieval and enterobiliary bypass. We present a case report of a patient with hilar cholangiocarcinoma managed laparoscopically. The nodal yield was nine...
February 2016: Indian Journal of Surgery
Eduardo de Souza Martins Fernandes, Felipe Tavares de Mello, Joaquim Ribeiro-Filho, Asterio Pinto do Monte-Filho, Moacir Martins Fernandes, Romulo Juventino Coelho, Monique Couto Matos, Antonio Augusto Peixoto de Souza, Orlando Jorge Martins Torres
BACKGROUND: Hepatopancreatoduodenectomy is one of the most complex abdominal operations mainly indicated in advanced biliary carcinoma. AIM: To present 10-year experience performing this operation in advanced malignant tumors. METHODS: This is a retrospective descriptive study. From 2004 to 2014, 35 hepatopancreatoduodenectomies were performed in three different institutions. The most common indication was advanced biliary carcinoma in 24 patients (68...
March 2016: Arquivos Brasileiros de Cirurgia Digestiva: ABCD, Brazilian Archives of Digestive Surgery
Kensuke Kubota, Sho Hasegawa, Akito Iwasaki, Takamitsu Sato, Yuji Fujita, Kunihiro Hosono, Atsushi Nakajima, Ryutaro Mori, Ryusei Matsuyama, Itaru Endo
BACKGROUND AND STUDY AIMS: Neoadjuvant chemotherapy (NAC) may lead to a successful margin-negative resection in patients with initially unresectable locally advanced Klatskin tumor (IULAKT). Use of removable plastic stents is preferable for the safe implementation of NAC in patients with IULAKT to reduce the risk of recurrent cholangitis. Our aim was to evaluate the efficacy associated with the use of plastic stents placed across the stenosis and above the papilla (above stent) during NAC...
April 2016: Endoscopy International Open
Ashish Gupta, Bramhadatta Pattnaik, Ashim Das, Lileswar Kaman
Von Meyenburg complexes (VMCs), or bile duct microhamartomas, are among the constellation of defects of ductal plate malformation. These present as multiple small intrahepatic cysts and are diagnosed incidentally. Association of intrahepatic VMCs with a bile duct cancer has rarely been reported. We describe a case of a 53-year-old man presenting with obstructive jaundice. Biochemistry and radiology gave a provisional diagnosis of a resectable Klatskin tumour. The patient underwent right hepatectomy with common bile duct and caudate lobe excision...
2016: BMJ Case Reports
B Juntermanns, C D Fingas, G C Sotiropoulos, D Jaradat, A Dechêne, H Reis, S Kasper, A Paul, G M Kaiser
BACKGROUND: Perihilar cholangiocarcinoma (Klatskin tumor) is a rare tumor entity with an unfavorable prognosis despite optimal treatment. OBJECTIVES: The aim of the study is to investigate beneficial histopathological features and recommendations for surgery in perihilar cholangiocarcinoma to improve patients' long term survival. MATERIAL AND METHODS: 192 patients suffering from perihilar cholangiocarcinoma underwent attempted tumor resection between 1998 and 2008 at our clinic...
June 2016: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Boris Guiu, Patrick Chevallier, Alban Denys, Elisabeth Delhom, Marie-Ange Pierredon-Foulongne, Philippe Rouanet, Jean-Michel Fabre, François Quenet, Astrid Herrero, Fabrizio Panaro, Guillaume Baudin, Jeanne Ramos
PURPOSE: To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy. MATERIALS AND METHODS: Seven patients (mean age:63.6y[42-77y]) underwent trans-hepatic LVD for liver metastases (n = 2), hepatocellular carcinoma (n = 1), intrahepatic cholangiocarcinoma (n = 3) and Klatskin tumour (n = 1)...
April 18, 2016: European Radiology
Yanfeng Liu, Jingxian Sun, Dening Ma, Bin Jin, Zhenyu Shao, Jianbo Wang, Zongli Zhang
PURPOSE: This study aimed to identify the effect of percutaneous transhepatic biliary drainage (PTBD) combined with 3-dimensional conformal radiotherapy (3D-CRT) in comparison with PTBD therapy only on the treatment of unresectable Klatskin tumors (KTs). MATERIALS AND METHODS: Thirty-seven patients with unresectable KTs were included in the study. Twenty-six patients received PTBD and 3D-CRT successively, whereas the other 11 patients received PTBD only. Changes in the clinical symptoms after the PTBD treatment, the radiotherapy effect, and the survival time were recorded and analyzed...
July 2016: Journal of Clinical Gastroenterology
Fabio Corvino, Luca Centore, Emilio Soreca, Antonio Corvino, Vincenzo Farbo, Alfonso Bencivenga
BACKGROUND: This study evaluated the technical and clinical efficacy of percutaneous bilateral biliary stent-in-stent (SIS) deployment technique with a "Y" configuration using open-cell-design stents in type 4 Klatskin tumor patients. METHODS: Retrospective evaluation ten patients with type IV Bismuth malignant hilar stricture (MHS) treated with percutaneous bilateral "Y" SIS deployment technique placement followed in our institution between March of 2012 and November of 2014...
April 2016: Journal of Gastrointestinal Oncology
Yu O Zharikov, T V Shevchenko, A V Chzhao
The treatment of tumours of proximal hepatic ducts (Klatskin tumours) remains a serious challenge because most patients are referred to the clinic at later stages of the disease. Its most common symptom is obstructive jaundice syndrome. Various methods of bile tract decompression have been proposed to resolve manifestations of this syndrome in the course of preoperative preparation for surgery of potentially resectable tumours and palliative treatment of incurable neoplasms. However analysis of the literature shows that the choice of an adequate method for the purpose remains a matter of debate...
2015: Klinicheskaia Meditsina
Edyta Iwaniec-Karlikowska, Monika Augustyn, Iwon Grys
UNLABELLED: Cholangiocarcinoma (CCA) is the second most frequent liver malignancy, responsible for 10-15% primary liver cancers. This tumor is difficult to diagnose and characterized by high mortality rate. Extrahepatic CCA is a specific type known as Klatskin tumor. A CASE REPORT: The patient was admitted to the Clinic of Internal Medicine and Gastroenterology with intrahepatic cholestasis. Imaging revealed Bismuth type IV hilum tumor. Due to rare occurrence of this malignancy the patient was directed to the tertiary center...
February 2016: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
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