Ann Hepatobiliary Pancreat Surg.  2016 Nov;20(4):173-179. 10.14701/ahbps.2016.20.4.173.

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

• Park HM
• Hur YH
• Cho CK
• Koh YS
• Kim HJ
• Park EK

• KMID: 2362467
• DOI: http://doi.org/10.14701/ahbps.2016.20.4.173

Abstract

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.

Keyword

Hepatolithiasis; Biliary neoplasm; Cholangiocarcinoma; Major hepatectomy

MeSH Terms

Abdominal Abscess
Bile
Bile Ducts
Cholangiocarcinoma
Constriction, Pathologic
Hepatectomy*
Humans
Incidence*
Medical Records
Mucins
Pleural Effusion
Pneumonia, Aspiration
Postoperative Complications
Retrospective Studies
Risk Factors
Wound Infection
Mucins

Figure

• 

  Fig. 1 Flow chart of patient selection for hepatic resection.

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