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Intraductal ultrasonography combined with percutaneous transhepatic cholangioscopy for the preoperative evaluation of longitudinal tumor extent in hilar cholangiocarcinoma.

Authors
 Hee Man Kim  ;  Jeong Youp Park  ;  Kyung Sik Kim  ;  Mi-Suk Park  ;  Myeong-Jin Kim  ;  Young Nyun Park  ;  Seungmin Bang  ;  Si Young Song  ;  Jae Bock Chung  ;  Seung Woo Park 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.25(2) : 286-292, 2010 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2010
MeSH
Aged ; Bile Duct Neoplasms/diagnosis* ; Bile Duct Neoplasms/diagnostic imaging ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/surgery ; Biopsy ; Cholangiocarcinoma/diagnosis* ; Cholangiocarcinoma/diagnostic imaging ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/surgery ; Cholangiopancreatography, Magnetic Resonance ; Endoscopy, Digestive System* ; Endosonography* ; Female ; Hepatic Duct, Common/diagnostic imaging* ; Hepatic Duct, Common/pathology* ; Hepatic Duct, Common/surgery ; Humans ; Klatskin Tumor/diagnosis* ; Klatskin Tumor/diagnostic imaging ; Klatskin Tumor/pathology ; Klatskin Tumor/surgery ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Positron-Emission Tomography ; Predictive Value of Tests ; Preoperative Care ; Sensitivity and Specificity ; Tomography, X-Ray Computed
Keywords
hilar cholangiocarcinoma ; intraductal ultrasonography ; percutaneous transhepatic cholangioscopy
Abstract
BACKGROUND AND AIM: In hilar cholangiocarcinoma, an accurate assessment of preoperative resectability is important to optimize surgical resection. We investigated the accuracy of the combination of intraductal ultrasonography (IDUS) and percutaneous transhepatic cholangioscopy (PTCS) for evaluating longitudinal extent in hilar cholangiocarcinoma. METHODS: Patients diagnosed with hilar cholangiocarcinoma underwent multidetector computed tomography (MDCT) and magnetic resonance cholangiography (MRC) for tumor staging and Bismuth type. Percutaneous transhepatic biliary drainage was performed at the left or right bile duct of the liver section that was anticipated to be preserved in the surgical treatment. After tract dilation, PTCS with cholangioscope-directed biopsy and IDUS were sequentially performed to evaluate Bismuth type. Surgical treatment was executed according to tumor staging and longitudinal tumor extent. Postoperative histological Bismuth types were compared to preoperative Bismuth types based on MDCT, MRC, PTCS with biopsy, and IDUS. RESULTS: From June 2006 to November 2008, 25 patients with hilar cholangiocarcinoma were enrolled, with 20 of these patients evaluable. The accuracy of MDCT, MRC, PTCS with biopsy, and IDUS for the evaluation of Bismuth type was 80%, 84.2%, 90%, and 85.0%, respectively, in 20 patients, and 82.4%, 82.4%, 94.1%, and 88.2%, respectively, in 18 patients with Bismuth type IIIa, IIIb, or IV cancer. The accuracy of the combination of IDUS and PTCS with biopsy was 95% in 20 patients, and 100% in 18 with Bismuth type IIIa, IIIb, or IV cancer. CONCLUSIONS: The combination of IDUS and PTCS with biopsy was highly accurate for assessing Bismuth type and may help in the identification of an optimal surgical plan for the treatment of hilar cholangiocarcinoma, especially in Bismuth type IIIa, IIIb, or IV.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2009.05944.x/abstract
DOI
10.1111/j.1440-1746.2009.05944.x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Mi-Suk(박미숙) ORCID logo https://orcid.org/0000-0001-5817-2444
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Park, Jeong Youp(박정엽) ORCID logo https://orcid.org/0000-0003-0110-8606
Bang, Seungmin(방승민) ORCID logo https://orcid.org/0000-0001-5209-8351
Song, Si Young(송시영) ORCID logo https://orcid.org/0000-0002-1417-4314
Chung, Jae Bock(정재복)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/101659
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