The Range of Resection in Hilar Cholangiocarcinoma -Cholangiographic and Cholangioscopic Diagnosis of Cancer Extension-

Eiji Sakamoto, Yuji Nimura, Junichi Kamiya, Satoshi Kondo, Masato Nagino, Michio Kanai, Masahiko Miyachi, Katsuhiko Uesaka

First Department of Surgery, Nagoya University School of Medicine

One hundred and twenty-three patients underwent resection of hilar cholangiocarcinoma in our department during the last 18 years. The resected specimens and preoperative image diagnosis were compared in detail, and the accuracy of the preoperative estimation of proximal cancer extension was examined. The accuracy was expressed as the percentage of the patients whose cancer extension was correctly estimated within 5 mm. As for mucosal extension, the accuracy of cholangiographic estimation was 95% in cases without superifical spread of cancer. Howerver, in cases with superifical spread (n=12), it was impossible to estimate the mucosal extension without PTCS. The accuracy of cholangioscopic estimation of the superifical spread was 78%. On the other hand, the submucosal extension of the cancer was estimated by detecting biliary stiffness, tapering, and narrowing on hihg-quality selected cholangiograms achieved via PTBD in various positions. The accuracy of cholangiographic estimation of submucosal extension was 71%.

Key words
hilar cholangiocarcinoma, percutaneous transhepatic biliary drainage, percutaneous transhepatic cholangioscopy

Reprint requests
Eiji Sakamoto First Department of Surgery, Nagoya University School of Medicine
65 Tsurumai-cho, Showa-ku, Nagoya, 466 JAPAN

Accepted
July 2, 1997

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