Malignant masquerade at the hilum of the liver

Author:

Hadjis N S1,Collier N A1,Blumgart L H1

Affiliation:

1. Hepatobiliary Unit, Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, Ducane Road, London W12 0HS, UK

Abstract

Abstract Eight patients with biliary obstruction and a pre-operative diagnosis of a neoplastic lesion at the confluence of the hepatic ducts were found postoperatively to have benign disease. Cholangiography was highly suggestive of a malignant stricture in all patients. Angiography performed in six patients indicated that the lesions were potentially resectable. Seven patients underwent elective surgery; in six the ductal confluence including the lesion was removed, without mortality. Six patients are alive, five of them totally asymptomatic, in a median follow-up of 32 months. Many patients with hilar strictures are treated for what appears radiologically to be a neoplastic lesion. Since treatment often involves the placement of an endoprosthesis or palliative surgery, without histological diagnosis, some of these patients with benign disease are likely to be treated inappropriately, unless they are considered for a curative resection.

Funder

Department of Diagnostic Radiology

Department of Experimental Pathology

Cancer Research Campaign

Publisher

Oxford University Press (OUP)

Subject

Surgery

Reference27 articles.

1. Surgical approaches to cholangiocarcinoma at confluence of hepatic ducts;Blumgart;Lancet,1984

2. Evaluation of aggressive surgery for carcinoma of the extrahepatic bile ducts;Evander;Ann Surg,1980

3. Carcinoma of the hepatic hilus. Surgical management and the case for resection;Launois;Ann Surg,1979

4. Treatment of hilar cholangiocarcinoma by biliary drainage and internal radiotherapy;Fletcher;Br J Surg,1984

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