Hilar Bile Duct Carcinoma with Superficial Spread to the Duodenal Side of the Common Bile Duct: Report of Two Cases

Naomasa Uesugi, Katsura Tanzan, Eiichiro Yamaguchi, Takashi Nakamura, Motohiro Takesige, Norichika Matsui*, Kentaro Nishi* and Tomoaki Morita*

Department of Surgery, Shunan Memorial Hospital
Department of Surgery, Shuto General Hospital*

We report 2 cases of hilar bile duct carcinoma with superficial spread to the duodenal side of the common bile duct. The first patient, a 46-year-old man who underwent extended left hepatic lobectomy with caudate lobectomy for hilar bile duct carcinoma, during which the distal side of the common bile duct was divided at the intrapancreatic bile duct, was found histologically to have a frozen section with superficial spread of cancer cells to the resection margin, necessitating pancreatoduodenectomy. The second patient, a 66-year-old man referred for surgical treatment of hilar bile duct carcinoma, initially underwent extended right hepatic lobectomy with caudate lobectomy and division of the distal side of the common bile duct at the intrapancreatic bile duct. Postoperative histological examination showed superficial spread of carcinoma to the resection margin, necessitating pancreatoduodenectomy as a second-stage operation. Both surgical specimens contained a nodular-infiltrating tumor, and histopathological findings showed well-differentiated tubular adenocarcinoma. Hilar bile duct carcinoma with superficial spread to the proximal margin has been described in a number of reports, but few reports exist on the superficial spread of hilar bile duct carcinoma to the distal margin.

Key words
hilar bile duct carcinoma, superficial spread of carcinoma

Reprint requests
Naomasa Uesugi Department of Surgery, Shunan Memorial Hospital
1-10-1 Ikunoyaminami, Kudamatsu-City, 744-0033 JAPAN

Accepted
November 26, 2003

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