A Case of Intrahepatic Cholangiocarcinoma with Intrahepatic Stones

Keitaro Seto¹⁾, Yoshinao Ashida¹⁾, Ichiro Kita¹⁾, Shigeki Takashima^{1) 2)}, Yoshio Kinami^{1) 2)}

The Second Department of Surgery¹⁾, and The Division of Cancer Research, Medical Research Insutitute²⁾, Kanazawa Medical University

A case of cholangiocarcinoma acompanied with hepatolithiasis in a 44-year-old man is reported. This patient visited our hospital because of persisting dull pain in the left hypochondrium and fever over 39°C, and received a diagnosis of a tumor in the lateral segment and lithiasis in the medial segment of the left lobe, by ultrasonography, endoscopic retrograde cholangiography and computed tomography. A left hepatectomy was performed for the hepatolithiasis and cholangiocarcinoma was diagnosed by intraoperative pathological examination of frozen sections. The composition of bile acids in the intraductal bile around the tumor was analyzed by high performance liquid chromatography. The percentage of chenodeoxycholic acid, one of the primary bile acids, was 60%, and that of cholic acid was 29.4%. On the other hand, the ratio of glycine to taurine-conjugated bile acids was 2.1. These results suggest a relationship between carcinogenesis in the bile duct and bile acids.

Key words
hepatolithiasis, cholangiocarcinoma, bile acid

Reprint requests
Keitaro Seto Second Department of Surgery, Kanazawa Medical University
Uchinada, Ishikawa, 920-02 JAPAN

Accepted
October 9, 1991

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