Two Cases of Non-specific Chronic Cholangitis at the Hepatic Hilum Masquerading Hilar Cholangiocarcinoma

Yukihiro Yokoyama, Shinya Watanabe, Hideki Nishio, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara and Masato Nagino

Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine

We report two cases of benign biliary stricture in the hepatic hilum diagnosed as malignant biliary stricture. Both had obstructive jaundice and required biliary drainage. Computed tomography (CT) showed abdominal lymph node swelling, but cholangiography showed no primary sclerosing cholangitis. The bile duct in the hepatic hilum showed severe stenosis predominantly on the right side. Both cases were diagnosed as Bismuth type IIIa hilar cholangiocarcinoma. We conducted right hepatectomy and caudate lobectomy with extra hepatic bile duct resection. Pathological findings indicated extensive lymphoplasmacytic inflammatory infiltration under bile duct mucosa. The definitive diagnosis was chronic cholangitis with no finding of malignancy. When diagnosing a case of biliary stricture in the hepatic hilum, one should consider the possibility of benign biliary stricture other than hilar cholangiocarcinoma.

Key words
hilar cholangiocarcinoma, benign biliary stricture, chronic cholangitis

Reprint requests
Yukihiro Yokoyama Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550 JAPAN

Accepted
July 22, 2009

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