Incidence of underlying biliary neoplasm in patients after major hepatectomy for preoperative benign hepatolithiasis

Hyeong Min Park; Young Hoe Hur; Chol Kyoon Cho; Yang Seok Koh; Hee Joon Kim; Eun Kyu Park

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저자정보: Hyeong Min Park (Chonnam National University) Young Hoe Hur (Chonnam National University) Chol Kyoon Cho (Chonnam National University) Yang Seok Koh (Chonnam National University) Hee Joon Kim (Chonnam National University) Eun Kyu Park (Chonnam National University)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제20권 제4호

발행연도: 2016.11

수록면: 173 - 179 (7page)

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Backgrounds/Aims: Despite hepatolithiasis being a risk factor for biliary neoplasm including cholangiocarcinoma, the incidence of underlying biliary neoplasm is unknown in patients with preoperative benign hepatolithiasis. The aim of this study was to evaluate the incidence of underlying biliary neoplasm in patients who underwent major hepatectomy for preoperative benign hepatolithiasis. Methods: Between March 2005 and December 2015, 73 patients who underwent major hepatectomy for preoperative benign hepatolithiasis were enrolled in this study. The incidence and pathological differentiation of concomitant biliary neoplasm were retrospectively determined by review of medical records. Postoperative complications after major hepatectomy were evaluated. Results: Concomitant biliary neoplasm was pathologically confirmed in 20 patients (27.4%). Biliary intraepithelial neoplasia (BIN) was detected in 12 patients (16.4%), and 1 patient (1.4%) had intraductal papillary mucinous neoplasm (IPMN), as the premalignant lesion. Cholangiocarcinoma was pathologically confirmed in 7 patients (9.6%). Preoperative imaging of the 73 patients revealed biliary stricture at the first branch of bile duct in 31 patients (42.5%), and at the second branch of bile duct in 39 patients (53.4%). Postoperative complications developed in 14 patients (19.1%). Almost all patients recovered from complications, including intra-abdominal abscess (9.6%), bile leakage (4.1%), pleural effusion (2.7%), and wound infection (1.4%). Only 1 patient (1.4%) died from aspiration pneumonia. Conclusions: The incidence of underlying biliary neoplasm was not negligible in the patients with hepatolithiasis, despite meticulous preoperative evaluations.

#Hepatolithiasis #Biliary neoplasm #Cholangiocarcinoma #Major hepatectomy

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