Sánchez FP, Blanco BR, Andrade GJ

Language: Spanish
References: 14
Page: 357-361
PDF size: 319.74 Kb.

ABSTRACT

Objective: To describe a case of papillary carcinoma of the biliary tract.
Setting: Third level health care hospital.
Case description: A 77 years old man, who was admitted to the hospital with a diagnosis of jaundice syndrome, with two months evolution, without abdominal pain, fever of 38ºC, choluria and acholia, without weight loss. Hepatic function tests revealed: hyperbilirubinemia of 14.1 mg/dl, indirect of 10.1 mg/dl, alkaline phosphatase of 350 U, the remainder tests were normal. Imaging studies (ultrasound, retrograde endoscopic cholangiography, and abdominal computed tomography) revealed dilation of the intrahepatic biliary tract, obstruction at the confluence of the hepatic ducts due to a tumor extending from the intrahepatic biliary tract to the proximal extrahepatic tract. He was surgically explored, with the following findings: cholestatic liver, increase of the biliary tract diameter above the insertion of the cystic duct into the comun hepatic duct. During biliary tract exploration, a cerebroid and polypoid material was extracted, which was sent for histopathological examination. A T catheter was implanted, which has been kept closed for one year. The histopathologic report was of papillary adenocarcinoma moderately differentiated. The patient has been under surveillance for two years with laboratory tests and cholangiographies through the T catheter.

REFERENCES

1. Ochoa Carrillo FJ. Colangiocarcinoma. Rev Gastroenterol Mex 1997; 62: 194-201.

2. Henson DE, Albores-Savedra J, Corle D. Carcinoma of the extrahepatic bile ducts: histologic types, stage of disease, grade, and survival rates. Cancer 1992; 70: 1498-501.

3. Stain SC, Baer HU, Dennison AR, Blumgart LH. Current management of hilar cholangiocarcinoma Surg Gynecol Obstet 1992; 175: 579-88.

4. Bhuiya MR, Nimuro Y, Kamiya J, Kondo S, Fukata S, Hayakawa N, et al. Clinicopathologic studies on perineural invasion of bile duct carcinoma. Ann Surg 1992; 215: 344-9.

5. Extrahepatic bile ducts In: American Joint Committee on Cancer. Manual for Staging of Cancer. Philadelphia JB Lippincott Company 4th ed. 1992: 99-103.

6. Pichlmayr R, Weimann A, Klempnauer J, Oldhafer KJ, Maschek H, Tusch G, et al. Surgical treatment in proximal bile duct cancer. A single-center experience. Ann Surg 1996; 224: 628-38.

7. Su CH, Tsay SH, Wu CC, Shyr YM, King KL, Lee CH, et al. Factors influencing postoperative morbidity, mortality, and survival after resection for hilar cholangiocarcinoma. Ann Surg 1996; 223: 384-94.

8. Baer HU, Stain SC, Dennison AR, Eggers B, Blumgart LH. Improvements in survival by aggressive resections of hilar cholangiocarcinoma. Ann Surg 1993; 217: 20-7.

9. Beazley RM, Hadjis N, Benjamin IS, Blumgart LH. Clinicopathological aspects of high bile duct cancer. Experience with resection and bypass surgical treatments. Ann Surg 1984; 199: 623-36.

10. Lai ECS, Mok FPT, Fan ST, Lo CM, Chu KM, Liu CL, et al. Preoperative endoscopic drainage for malignant obstructive jaundince. Br J Surg 1994; 81: 1195-8.

11. Parc YP, Frileux P, Balladur P, Delva E, Harnnoun L, Pare R. Surgical strategy for the management of hilar bile duct cancer. Br J Surg 1997; 84: 1675-9.

12. Kahai M, Nimura Y, Kamiya J, Kondo S, Nagino M, Miyachi M, et al. Preoperative intrahepatic segmental cholangitis in patients with advanced carcinoma involving the hepatic hilus. Surgery 1996; 119: 498-504.

13. Kurosaki I, Tsukada K, Hatakeyama K, Muto T. The mode of lymphatic spread in carcinoma of the bile duct. Am J Surg 1996; 172: 239-43.

14. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma. Ann Surg 1992; 215: 31-8.