Objective: To summarize the experience in diagnosis and surgical treatment of peripheral intrahepatic cholangiocarcinoma (PICC).
Methods: Clinicopathological features, surgical treatment and prognosis of 20 patients with PICC treated in our hospital from 1970 to 1999 were retrospectively analyzed.
Results: The patients lacked typical clinical manifestations and some had a history of hepatitis B (35%), cirrhosis (45%), and elevation of serum alpha-fetaprotein (AFP) (25%). The diagnostic rates of ultrasound examination (BUS), CT, MRI and emission computerized tomography (ECT) were 90% (18/20), 94% (17/18), 100% (3/3) and 100% (4/4), respectively. However, the liver lesions detected by these methods needed to be differentiated from hepatocellular carcinoma (HCC), metastatic neoplasm and liver cyst, etc. In all the patients, the resection rate was 60% (12/20) and postoperative overall 1-, 3- and 5-year survival rates were 55% (11/20), 35% (7/12) and 20% (4/20), respectively. The liver resection rates were 83% (11/12), 58% (7/12) and 33% (4/12), respectively. Of the 4 patients who had survived for more than 5 years, 3 had a small liver carcinoma with a diameter less than or equal to 3 cm and one had large nodular liver carcinoma with intact capsule. After operation, all the patients received selective hepatic artery perfusion chemotherapy.
Conclusion: PICC patients lack specific serum tumor marker can achieve good survival after early detection and curative resection with adjuvant therapies.