Diagnosis and surgical treatment of intrahepatic hepatolithiasis combined with cholangiocarcinoma

World J Surg. 2014 Aug;38(8):2097-104. doi: 10.1007/s00268-014-2476-4.

Abstract

Background: The aim of the present study was to describe the clinical features and to assess surgical treatment of intrahepatic hepatolithiasis combined with cholangiocarcinoma (IHCC).

Methods: A total of 107 patients with histopathologically proven IHCC were included in the study and were divided into four groups as follows: the curative resection (CR) group, the palliative resection (PR) group, the radiofrequency ablation (RA) group, and the simple laparotomy group. Demographics, symptoms, and treatment were described and survival data were retrospectively analyzed.

Results: The overall survival rates were 45.4, 29.8, and 20.2% at 1, 3, and 5 years. The cumulative survival rates in the CR group at 1, 3, and 5 years were 71.1, 57.9, and 50.0%, respectively, which was significantly higher than for the other three groups (P < 0.01). The survival rates in the PR group at 1, 3, and 5 years were 50.0, 19.2, and 0%, and those in the RA group were 46.2, 8.3, and 0%. There was no statistically significant difference between the two groups. In the CR group, the cumulative survival rates of the patients with stage III tumor at 1, 3, and 5 years were 74.1, 63.0, and 59.3%, which were significantly higher than those of the patients with stage IV disease (P = 0.043).

Conclusions: The prognosis of IHCC is poor. Curative resection should be considered first, and radiofrequency ablation is a good choice for the patients for whom resection is impossible.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bile Duct Neoplasms / complications
  • Bile Duct Neoplasms / pathology*
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic*
  • Catheter Ablation
  • Cholangiocarcinoma / complications
  • Cholangiocarcinoma / pathology*
  • Cholangiocarcinoma / surgery*
  • Female
  • Hepatectomy
  • Humans
  • Lithiasis / complications
  • Lithiasis / surgery*
  • Liver Diseases / complications
  • Liver Diseases / surgery*
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Palliative Care
  • Prognosis
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome