Abstract
The association of hepatolithiasis (HL) and peripheral cholangiocarcinoma (PCC) has been well recognized. However, information concerning the impact of hepatolithiasis on patients with peripheral cholangiocarcinoma is sparse and therefore difficult to assess. A total of 162 consecutive patients with histologically proven peripheral cholangiocarcinoma were treated surgically at Chang-Gung Memorial Hospital between 1977 and 1994. Among them, 106 patients (65.4%) had associated hepatolithiasis (PCC + HL group), and the remaining 56 patients (34.6%) did not (the PCC − HL group). The differences in demographics, symptomatology, laboratory data, tumor staging, histological pattern, resectability rates, and long-term survival of these two groups were compared. The male to female ratio was 0.7 in the PCC + HL group and 1.3 in the PCC − HL group (P < 0.05). Two thirds of the PCC + HL group presented with acute cholangitis, whereas two thirds of the PCC − HL group presented with hepatomegaly (P < 0.01). Those patients in the PCC + HL group were in earlier stages than those of the PCC − HL group at the time of the initial diagnosis (P < 0.05). The resectability rate for the PCC + HL group was 31.1% and for the PCC − HL group, 26.8% (P > 0.05). Surgical mortality rates were 3.8% in the PCC + HL group and 3.6% in the PCC − HL group (P > 0.05). The morbidity rate was much higher in the PCC + HL group than in the PCC − HL group (P < 0.01). The 1-, 3-, and 5-year survival rates were 35.5%, 20.5%, and 16.5% in the PCC + HL group and 27.2%, 8.8%, and 7.8% in the PCC − HL group (P > 0.05). In conclusion, the presence of hepatolithiasis hindered an exact diagnosis of underlying cholangiocarcinoma preoperatively, precipitated biliary sepsis which affected resectability, and increased postoperative morbidity. Hepatolithiasis per se, however, did not influence the long-term survival.
Similar content being viewed by others
REFERENCES
Parkin DM, Ohshima H, Srivatanakul P, et al: Cholangiocarcinoma: Epidemiology, mechanisms of carcinogensis and prevention. Cancer Epidemiol Biomarkers Prev 2:537-544, 1993
Vauthey JN, Blumgart LH: Recent advances in the management of cholangiocarcinomas. Semin Liver Dis 14:109-114, 1994
Sane S, MacCallum JD: Primary carcinoma of the liver. Cholangiocarcinoma in hepatolithiasis. Am J Pathol 18:675-683, 1942
Koga A, Ichimiya H, Yamaguchi K, et al: Hepatolithiasis associated with cholangiocarcinoma. Possible etiological significance. Cancer 55:2826-2829, 1985
Sheen-Chen SM, Chou FF, Eng HL: Intrahepatic cholangiocarcinoma in hepatolithiasis: A frequently overlooked disease. J Surg Oncol 47:131-135, 1991
Chen MF, Jan YY, Wang CS, et al: Intrahepatic stone associated with cholangiocarcinoma. Am J Gastroenterol 84:391-395, 1989
Yoshimoto H, Ikeda S, Tanako M, et al: Intrahepatic cholangiocarcinoma associated with hepatolithiasis. Gastrointest Endosc 31:260-263, 1985
Chen MF, Jan YY, Wang CS, et al: A reappraisal of cholangiocarcinoma in patients with hepatolithiasis. Cancer 71:2461-2465, 1993
Jan YY, Chen MF: Surgical treatment of peripheral cholangiocarcinoma. Asian J Surg 19:105-111, 1996
Fleming ID, Cooper JS, Henson DE, Hutter RVP, Kennedy BJ, Murphy GP, et al (eds): American Joint Committee on Cancer Staging Manual, 5th ed. Philadelphia, JB Lippincott, 1997
Su CH, Shyr YM, Lui WY: Hepatolithiasis associated with cholangiocarcinoma. Br J Surg 84:969-973, 1997
Nakeeb A, Pitt HA, Sohn TA, et al: Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463-475, 1996
Washburn WK, Lewis WD, Jenkins RL: Aggressive surgical resection for cholangiocarcinoma. Arch Surg 130:270-276, 1995
Jan YY, Jeng LB, Hwang TL, Chen MF: Factors influencing survival after hepatectomy for peripheral cholangiocarcinoma. Hepatogastroenterol 43:614-619, 1996
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Chen, MF., Jan, YY., Hwang, TL. et al. Impact of Concomitant Hepatolithiasis on Patients with Peripheral Cholangiocarcinoma. Dig Dis Sci 45, 312–316 (2000). https://doi.org/10.1023/A:1005460509677
Issue Date:
DOI: https://doi.org/10.1023/A:1005460509677