A Case Report of Cholangiocarcinoma after Lateral Segmentectomy for Intrahepatic Stones

Nobuhiro Kai, Kazuhide Ura, Junichiro Furui, Masashi Yamada, Tsutomu Tomioka, Norihiro Kohara, Teiji Matsumoto, Toshifumi Eto, Toru Segawa, Koichi Motojima, Tsukasa Tsunoda, Kunihide Izawa*

The Second Department of Surgery and *Emergency, Nagasaki University School of Medicine

Once case of cholangiocarcinoma after lateral segmentectomy for intrahepatic stones is reported. A 57-year-old male underwent lateral segmentectomy for intrahepatic stones when he was 47 years old, and endoscopic sphincterotomy for common bile duct stone when he was 51 years old. He was referred to the hospital because of epigastralgia and fever in 1989. Ultrasonography and computed tomography revealed a large tumor in the liver. The tumor seemed to arise from the cross section of the liver, invaded to the rest of the liver, abdominal wall, thoracic cavity and pericardium. Emergency surgical drainage was needed for the suppurative pericarditis and cardiac tamponade after 2 days radiation therapy. The cause of this rare complication was possibly the invasion of the carcinoma to the pericardium. Intrahepatic stones seemed to be a high risk state of cholangiocarcinoma. To get the diagnosis of cholangiocarcinoma preoperatively is usually difficult, and the outcome of patients are poor. We have to consider about the possibility of cholangiocarcinoma when the procedure for treatment is decided for intrahepatic stones.

Key words
intrahepatic stones, cholangiocarcinoma, hepatectomy

Reprint requests
Nobuhiro Kai The Second Department of Surgery, Nagasaki University School of Medicine
7-1 Sakamoto, Nagasaki, 852 JAPAN

Accepted
November 20, 1991

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