A Case of Unresectable Hilar Cholangiocarcinoma Survived Long after Triple Expandable Metallic Stenting for Bile Duct, Portal Vein and Pyrolic Ring

Takayuki Nishikawa, Akishige Kanazawa, Chikaharu Sakata, Miyuki Fujita, Satoshi Kiyota, Takaaki Hori, Taigo Tokuhara and Harushi Osugi*

Department of Surgery, Asakayama General Hospital
Department of Gastroenterological Surgery, Osaka City University, Graduate School of Medicine*

A 61-year-old man referred for a diagnosis of obstructive jaundice on February 3, 2001, was found in further examination to have unresectable hilar cholangiocarcinoma invading the portal vein and hepatic artery. We inserted an expandable metallic stent into the portal vein on April 4 for portal stenosis caused by invasion and into the common bile duct through the right anterior brunch for biliary stenosis on May 2. After follow-up for 24 months without any remarkable change, the man developed nausea and vomiting. Endoscopy showed stricture of the prepyrolic region due to extramural compression. Insertion of a third stent into the gastrointestinal stricture effectively enabled the man to eat orally. Unfortunately, be died of peritonitis carcinomas after being followed up as an out-patient with good QOL for 26 months after the first stenting.

Key words
expandable metallic stent, advanced hilar cholangiocarcinoma

Reprint requests
Takayuki Nishikawa Department of Gastroenterological Surgery, Osaka City University, Graduate School of Medicine
1-4-3 Asahimachi, Abenoku, Osaka, 545-8585 JAPAN

Accepted
January 26, 2005

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