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Hilar cholangiocarcinoma

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https://www.readbyqxmd.com/read/28338651/dichotomy-in-intrahepatic-cholangiocarcinomas-based-on-histologic-similarities-to-hilar-cholangiocarcinomas
#1
Masayuki Akita, Kohei Fujikura, Tetsuo Ajiki, Takumi Fukumoto, Kyoko Otani, Takeshi Azuma, Tomoo Itoh, Yonson Ku, Yoh Zen
Intrahepatic cholangiocarcinomas were classified into two types based on their microscopic appearance. Tumors with histologic similarities to hilar cholangiocarcinomas (predominantly ductal adenocarcinomas with minor tubular components, if present, restricted to the invasive front) were defined as the perihilar type, whereas the others were classified as peripheral cholangiocarcinomas. Among the 47 cases examined in the present study, 26 (55%) were classified as the perihilar type, whereas 21 (45%) were the peripheral type...
March 24, 2017: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
https://www.readbyqxmd.com/read/28334429/liver-parenchyma-transection-first-approach-in-hemihepatectomy-with-en-bloc-caudate-lobectomy-for-hilar-cholangiocarcinoma-a-safe-technique-to-secure-favorable-surgical-outcomes
#2
Yasunari Kawabata, Hikota Hayashi, Seiji Yano, Yoshitsugu Tajima
BACKGROUND: Although hemihepatectomy with total caudate lobectomy (hemiHx-tc) is essential for the surgical treatment of hilar cholangiocarcinoma, the advantage of an anterior approach for hemiHx-tc has not been fully discussed technically; the significance of an anterior approach without liver mobilization for preventing infectious complications also remains unknown. METHODS: The liver parenchyma transection-first approach (Hp-first) technique is an early transection of the hepatic parenchyma without mobilization of the liver that utilizes a modified liver-hanging maneuver to avoid damaging the future remnant liver...
March 23, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28302003/liver-transplant-for-nonhepatocellular-carcinoma-malignancy
#3
Nihan Haberal Reyhan
Liver transplant is now an acceptable and effective treatment for specific nonhepatocellular malignancies. Worldwide, hilar cholangiocarcinoma accounts for 3% of all primary gastrointestinal malignancies and for 10% of primary hepatobiliary malignancies. For patients who have early-stage, unresectable cholangiocarcinoma, liver transplant preceded by neoadjuvant radiotherapy can result in tumor-free margins, accomplish a radical resection, and treat the underlying primary sclerosing cholangitis when present...
March 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28290711/visualising-a-rare-and-complex-case-of-advanced-hilar-cholangiocarcinoma
#4
Jia Qu, Albert Fung, Paul Kelly, Gordon Tait, Paul D Greig, Anne Agur, Ian D McGilvray, Jodie Jenkinson
The Toronto Video Atlas of Liver, Pancreas, Biliary, and Transplant Surgery (TVASurg) is a free online library of three-dimensional (3D) animation-enhanced surgical videos, designed to instruct surgical fellows in hepato-pancreato-biliary (HPB) and transplant procedures. The video 'Klatskin tumours: Extended left hepatectomy with complex portal vein reconstruction and in situ cold perfusion of the liver', which is available to watch at http://TVASurg.ca , is a unique and valuable visual resource for surgeons in training to assist them in learning this rare procedure...
March 14, 2017: Journal of Visual Communication in Medicine
https://www.readbyqxmd.com/read/28280622/high-dose-chemoradiation-for-unresectable-hilar-cholangiocarcinomas-using-intensity-modulated-external-beam-radiotherapy-a-single-tertiary-care-centre-experience
#5
Reena Engineer, Shaesta Mehta, Nikhil Kalyani, Suresh Chaudhari, Tejas Dharia, Nitin Shetty, Supriya Chopra, Mahesh Goel, Suyash Kulkarni, Shyam Kishore Shrivastava
BACKGROUND: We present results of patients diagnosed with unresectable hilar cholangiocarcinomas treated with high dose radiotherapy and concurrent chemotherapy. METHODS: From Aug 2005 to Dec 2012, 68 consecutive patients were treated. Fifty patients (group 1) presenting to us with obstructive jaundice were planned for endobiliary brachytherapy (EBBT 14 Gy) followed external beam radiotherapy (EBRT 45 Gy). Twenty-two patients (group 2) who had previously undergone biliary drainage underwent EBRT (57 Gy)...
February 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28260715/immunoglobulin-g4-related-sclerosing-cholangitis-diagnosed-by-liver-biopsy-a-case-report
#6
Mitsuhiro Furuta, Hiroki Eguchi, Yoshiya Takeda, Kunihiro Fushiki, Takeshi Yasuda, Yuriko Onozawa, Masanobu Katayama, Motoo Tanaka, Tadashi Shigematsu, Masamichi Bamba
Patients with immunoglobulin (Ig) G4-related sclerosing cholangitis typically have a high serum IgG4 level. However, here we describe our experience of a patient with a normal serum IgG4 level for whom the cholangitis was diagnosed by liver biopsy. A 61-year-old male presented with elevated liver enzymes and a normal serum IgG4 level. The hilar, intrahepatic, and upper extrahepatic bile ducts were stenotic, with no evidence of a pancreatic lesion. We therefore performed a liver biopsy to differentiate between cholangiocarcinoma and primary sclerosing cholangitis...
2017: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
https://www.readbyqxmd.com/read/28238541/igg4-related-sclerosing-cholangitis-overlapping-with-autoimmune-hepatitis-report-of-a-case
#7
Hongyan Li, Li Sun, David R Brigstock, Lina Qi, Runping Gao
BACKGROUND: IgG4-related sclerosing cholangitis (IgG4-SC) is the biliary manifestation of IgG4-related disease (IgG4-RD) but the presence of IgG4-SC in the porta hepatis is difficult to differentiate from hilar cholangiocarcinoma (HCCA). IgG4-related autoimmune hepatitis (IgG4-related AIH) is extremely rare and it is not fully clear whether IgG4-related AIH is a hepatic manifestation of IgG4-RD or a subtype of AIH. CASE PRESENTATION: We present a rare case of a 52-year-old male who was admitted with obstructive jaundice and itchy skin...
February 10, 2017: Pathology, Research and Practice
https://www.readbyqxmd.com/read/28229077/surgical-therapy-of-cholangiocarcinoma
#8
REVIEW
Arnold Radtke, Alfred Königsrainer
BACKGROUND: The majority of patients with cholangiocarcinoma present with advanced disease that is often challenging to diagnose and to treat. The optimal preoperative evaluation requires a coordinated multidisciplinary approach. Surgical resection is the mainstay of therapy. METHODS: This systematic review delineates surgical treatment strategies for cholangiocarcinoma in general as well as special considerations concerning the particular tumor localization. A literature search (see keywords) was conducted using PubMed and publications between 1990 and 2016 regarding resectable and advanced cholangiocarcinoma were reviewed...
December 2016: Visceral Medicine
https://www.readbyqxmd.com/read/28208938/institutional-experience-in-the-management-of-hilar-liver-obstruction-a-series-of-13-cases
#9
Adithya Malolan Pathanki, Adithya V Naragund, Basant Mahadevappa
Neoplastic hilar obstruction to the liver outflow presents a unique challenge to the surgeon, wherein, the balance between a curative and possibly larger resection has to be achieved against a more conservative local resection. These are often technically demanding and have thus, far produced equivocal outcomes on both ends. The present case series is on 13 patients who presented with hilar obstruction. They all underwent resections with possible curative intent. The focus of our review is on the technical nuances and the strategies we used, intra- and peri-operatively to make resections possible in these patients, who at first look were deemed inoperable...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28168674/clinical-implications-of-biliary-confluence-pattern-for-bismuth-corlette-type-iv-hilar-cholangiocarcinoma-applied-to-hemihepatectomy
#10
Gu-Wei Ji, Fei-Peng Zhu, Ke Wang, Chen-Yu Jiao, Zi-Cheng Shao, Xiang-Cheng Li
BACKGROUND: Since biliary variations are commonly seen, our aims are to clarify these insidious variations and discuss their surgicopathologic implications for Bismuth-Corlette (BC) type IV hilar cholangiocarcinoma (HC) applied to hemihepatectomy. METHODS: Three-dimensional images of patients with distal bile duct obstruction (n = 97) and advanced HC (n = 79) were reconstructed and analyzed retrospectively. Normal biliary confluence pattern was defined as the peripheral segment IV duct (B4) joining the common trunk of segment II (B2) and segment III (B3) ducts to form the left hepatic duct (LHD) that then joined the right hepatic duct (RHD)...
April 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28133337/-a-case-of-peritoneal-dissemination-of-hilar-cholangiocarcinoma-presenting-with-hematuria-six-years-after-radical-surgery
#11
Noriaki Koizumi, Yuen Nakase, Hiroki Kobayashi, Tsuyoshi Takagi, Kanehisa Fukumoto
A 76-year-old man underwent radical surgery for Stage IV a hilar cholangiocarcinoma in July 2009, and had been followed at an outpatient clinic. Although no apparent recurrent lesion was detected by PET/CT examination, an elevated CA19-9 level was found in January 2014. He was then started on the oral anticancer drug S-1. However, his CA19-9 level increased gradually. The patient presented to a urological department with a complaint of macrohematuria in May 2015. Detailed examination revealed a mass lesion at the top of the urinary bladder, which was suspected to be peritoneal dissemination of the known hilar cholangiocarcinoma invading the urinary bladder wall...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133234/-a-case-of-primary-sclerosing-cholangitis-difficult-to-distinguish-from-a-hilar-cholangiocarcinoma
#12
Yutaka Umehara, Minoru Umehara, Shinji Tsutsumi, Akitoshi Kimura, Tomohisa Tokura, Kenichi Takahashi, Takayuki Morita
A 78-year-old man, who had presented with onset of ulcerative colitis at the age of 56 years and had been in remission for the past several years, attended our hospital with a diagnosis of obstructive jaundice. A hilar cholangiocarcinoma with right hepatic artery invasion was suspected on contrast enhanced CT. An endoscopic retrograde cholangiography indicated Bismuth type 2 stenosis. The stenotic bile duct brushings revealed no malignancy. Primary sclerosing cholangitis(PSC)and IgG4- related cholangitis were included in the differential diagnosis; however, a significant result could not be obtained in any other examinations...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28133066/-a-case-of-bismuth-iii-b-hilar-cholangiocarcinoma-resected-with-extended-left-hepatic-lobectomy-after-ercp-induced-pancreatitis
#13
Toru Mizutani, Hisashi Ikoma, Toshiyuki Kosuga, Hirotaka Konishi, Ryo Morimura, Yasutoshi Murayama, Shuhei Komatsu, Atsushi Shiozaki, Yoshiaki Kriu, Masayoshi Nakanishi, Daisuke Ichikawa, Hitoshi Fujiwara, Kazuma Okamoto, Toshiya Ochiai, Eigo Otsuji
Endoscopic retrograde cholangiopancreatography(ERCP)is widely accepted as the standard therapy before surgery for hilar cholangiocarcinoma. The patient is a 68-year-old man who presented with liver dysfunction. Computed tomography (CT)revealed abnormal lesions in his liver. He was referred to our hospital for therapy. We present a rare case of expansion of left lobectomy for Bismuth III b hilar cholangiocarcinoma after grade 2 severe pancreatitis caused by ERCP. He received arterial infusion therapy and endoscopic necrosectomy 6 times and percutaneous transhepatic biliary drainage(PTBD)...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28105359/clinical-analysis-of-cholangiocarcinoma-patients-receiving-adjuvant-radiotherapy
#14
Danupon Nantajit, Pornwaree Trirussapanich, Sunanta Rojwatkarnjana, Kamonwan Soonklang, Poompis Pattaranutraporn, Kanyanee Laebua, Sasikarn Chamchod
Cholangiocarcinoma (CCA) or bile duct cancer is a rare cancer type in developed countries, while its prevalence is increased in southeast Asia, affecting ~33.4 men and ~12.3 women per 100,000 individuals. CCA is one of the most lethal types of cancer. Neo-adjuvant and adjuvant therapies have been shown to have limited efficacy in improving the overall prognosis of patients. Radiotherapy has been reported to prolong the survival times of patients with certain characteristics. The present study retrospectively evaluated the medical records and follow-up data from 27 CCA patients who received radiotherapy at Chulabhorn Hospital (Bangkok, Thailand) between 2008 and 2014...
December 2016: Molecular and Clinical Oncology
https://www.readbyqxmd.com/read/28064203/predictive-factors-of-gastroduodenal-bleeding-after-postoperative-radiotherapy-in-biliary-tract-cancer
#15
Jieun Lee, Do Hoon Lim, Hee Chul Park, Jeong Il Yu, Dong Wook Choi, Seong Ho Choi, Jin Seok Heo
OBJECTIVE: To identify predictive factors for gastroduodenal bleeding after postoperative radiation therapy in patients with biliary tract cancer. METHODS: We identified 186 patients with biliary tract cancer who completed scheduled postoperative radiation therapy from March 2000 to August 2013. To isolate the effects of radiation on gastroduodenal bleeding, patients with pylorus-preserving pancreaticoduodenectomy, pylorus-resecting pancreaticoduodenectomy or Whipple surgery (n = 67) were excluded from this analysis...
January 6, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28059437/long-non-coding-rna-malat1-interacted-with-mir-204-to-modulates-human-hilar-cholangiocarcinoma-proliferation-migration-and-invasion-by-targeting-cxcr4
#16
Xinyu Tan, Zhiguo Huang, Xiaogang Li
Metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) is involved in the development and progression of many types of tumors. An aberrant expression of MALAT1 was observed in many kinds of cancers. However, the exact effects and molecular mechanisms of MALAT1 in human hilar cholangiocarcinoma (HCCA) progression are still unknown. Here, we investigated the role of MALAT1 in human HCCA cell lines and clinical tumor samples in order to determine the function of this lncRNA. In our research, lncRNA-MALAT1 was specifically upregulated in HCCA tissues and cell lines, and was associated with pathological T stage, a larger tumor size and perineural invasion...
January 6, 2017: Journal of Cellular Biochemistry
https://www.readbyqxmd.com/read/28058710/stereotactic-ablative-radiotherapy-for-patients-with-unresectable-or-medically-inoperable-cholangiocarcinoma
#17
Ming-Yueh Liu, Cheng-Hsiang Lo, Chun-Shu Lin, Hsing-Lung Chao, Jen-Fu Yang, Kuen-Tze Lin, Chao-Yueh Fan, Yu-Fu Su, Wen-Yen Huang
PURPOSE: The role of stereotactic ablative radiotherapy (SABR) in patients with unresectable or medically inoperable cholangiocarcinoma remains unclear. We examined the efficacy and safety of SABR in this group of patients. METHODS: From January 2008 to December 2014, 15 patients with 17 lesions were included in this study. The lesions included 14 intrahepatic, 1 hilar, and 2 distal bile duct tumors. Three patients were classified as medically inoperable because of old age or multiple comorbidities...
January 5, 2017: Tumori
https://www.readbyqxmd.com/read/27919853/endoscopic-bilateral-stent-in-stent-placement-for-malignant-hilar-obstruction-using-a-large-cell-type-stent
#18
Jin Myung Park, Sang Hyub Lee, Kwang Hyun Chung, Dong Kee Jang, Ji Kon Ryu, Yong-Tae Kim, Jae Min Lee, Woo Hyun Paik
BACKGROUND: Bilateral stent-in-stent (SIS) self-expandable metal stent placement is technically challenging for palliation of unresectable malignant hilar obstruction. In the SIS technique, the uniform large cell type biliary stent facilitates contralateral stent deployment through the mesh of the first metallic stent. This study aimed to assess the technical success and clinical effectiveness of this technique with a uniform large cell type biliary stent. METHODS: Thirty-one patients who underwent bilateral SIS placement using a large cell type stent were reviewed retrospectively...
December 2016: Hepatobiliary & Pancreatic Diseases International: HBPD INT
https://www.readbyqxmd.com/read/27914884/clinical-presentation-diagnosis-and-survival-in-cholangiocarcinoma-a-prospective-study
#19
Larisa Vasilieva, Stefanos I Papadhimitriou, Alexandra Alexopoulou, Ioannis Kostopoulos, Konstantinos Papiris, Dimitrios Pavlidis, Dimitrios Xinopoulos, Andreas Romanos, Spyridon P Dourakis
BACKGROUND AND STUDY AIMS: The diagnosis of cholangiocarcinoma (CCA) is difficult. The present study aimed to assess the clinical features, diagnosis, and survival in CCA. PATIENTS AND METHODS: This is a prospective study on 46 patients with CCA who underwent endoscopic retrograde cholangiopancreatography (ERCP) or surgical resection and 20 controls with a clinical and ERCP suspicion for CCA in whom surgical biopsy and/or 4-year follow-up showed a benign biliary stricture...
December 2016: Arab Journal of Gastroenterology: the Official Publication of the Pan-Arab Association of Gastroenterology
https://www.readbyqxmd.com/read/27896655/transhepatic-hilar-approach-for-perihilar-cholangiocarcinoma-significance-of-early-judgment-of-resectability-and-safe-vascular-reconstruction
#20
Naohisa Kuriyama, Shuji Isaji, Akihiro Tanemura, Yusuke Iizawa, Hiroyuki Kato, Yasuhiro Murata, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai
In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection...
March 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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