A Case of Primary Sclerosing Cholangitis Complicating Cholangiocarcinoma

Yoshiharu Nishimura, Hiroaki Takenaka, Kazuhiro lwase, Katsuhide Yoshidome, Takahito Ohnishi, Motohide Takagaki, Tohru Ishizaka, Toshiya Bessho, Toshihiro Oohata, Masayoshi Inoue, Senya Ohshima, Tomoyuki Tanaka*

Department of Surgery and Pathology*, Kinan General Hospital

A case of primary sclerosing cholangitis (PSC) complicating cholangiocarcinoma is reported. The patient, a 32-year-old female, was admitted to the hospital with obstructive jaundice. Cholangiographical evaluation revealed localized obstruction of the common bile duct. Although she was suspected of unremovable cholangiocarcinoma at laparotomy, the obstructed part of the common bile duct was not malignant histopathologically. After indwelling an internal drainage tube the patient was observed as PSC for 3 years and 5 months. Since the tube was obstructed repeatedly during the period, operation was indicated. Since atrophy was observed in the left lobe of the liver, the left lobe and common bile duct were removed and hepatocholangiojejunostomy was performed. On histopathological examination there were no malignant findings in the obstructed part of the common bile duct, but the development of cholangiocarcinoma was observed in the part of the left lobe of the liver. Only 2 cases of PSC complicating cholangiocarcinoma have been reported in Japan. We must pay attention to the possibility of the occurrence of cholangiocarcinoma in the treatment of PSC.

Key words
primary sclerosing cholangitis, cholangiocarcinoma

Reprint requests
Yoshiharu Nishimura Department of Surgery, Kinan General Hospital
510 Minato, Tanabe-shi, 646 JAPAN

Accepted
October 7, 1992

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