A case of carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis
The patients was seventy-year-old female with carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis. She underwent cholecytectomy, choledochotomr for hepatolithiasis and pancreaticojejunostomy for pancreatolithiasis in November,1991. She was d...
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| Published in | Tando Vol. 9; no. 4; pp. 342 - 347 |
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| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
Japan Biliary Association
1995
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| Subjects | |
| Online Access | Get full text |
| ISSN | 0914-0077 1883-6879 |
| DOI | 10.11210/tando1987.9.4_342 |
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| Abstract | The patients was seventy-year-old female with carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis. She underwent cholecytectomy, choledochotomr for hepatolithiasis and pancreaticojejunostomy for pancreatolithiasis in November,1991. She was discharged after the complete elimination of stone by the cholangioscopic lithotripsy with persistent dilatation of intra and extrahepatic bile duct. She was admitted to our hospital with complaints of fever, appetite loss and general fatigue about three years later. Percutaneous transhepatic cholangiography revealed filling defect of bile duct in the hepatic hilus and biopsy of the tumor through the cholangioscopy revealed adenocarcinoma. Resection of the extrahepatic bile duct was performed. Resected specimen showed nodular-type tumor at the left hepatic duct and its invasion to right hepatic duct. Histological examination revealed mucinous adenocarcinoma. This case indicated that resection of the involved segment of the liver and dilated bile duct on initial admission should be necessary because long-standing bile stasis and infection in dilated bile duct may induce the occurrence of carcinoma. |
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| AbstractList | The patients was seventy-year-old female with carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis. She underwent cholecytectomy, choledochotomr for hepatolithiasis and pancreaticojejunostomy for pancreatolithiasis in November,1991. She was discharged after the complete elimination of stone by the cholangioscopic lithotripsy with persistent dilatation of intra and extrahepatic bile duct. She was admitted to our hospital with complaints of fever, appetite loss and general fatigue about three years later. Percutaneous transhepatic cholangiography revealed filling defect of bile duct in the hepatic hilus and biopsy of the tumor through the cholangioscopy revealed adenocarcinoma. Resection of the extrahepatic bile duct was performed. Resected specimen showed nodular-type tumor at the left hepatic duct and its invasion to right hepatic duct. Histological examination revealed mucinous adenocarcinoma. This case indicated that resection of the involved segment of the liver and dilated bile duct on initial admission should be necessary because long-standing bile stasis and infection in dilated bile duct may induce the occurrence of carcinoma. The patients was seventy-year-old female with carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis. She underwent cholecytectomy, choledochotomr for hepatolithiasis and pancreaticojejunostomy for pancreatolithiasis in November,1991. She was discharged after the complete elimination of stone by the cholangioscopic lithotripsy with persistent dilatation of intra and extrahepatic bile duct. She was admitted to our hospital with complaints of fever, appetite loss and general fatigue about three years later. Percutaneous transhepatic cholangiography revealed filling defect of bile duct in the hepatic hilus and biopsy of the tumor through the cholangioscopy revealed adenocarcinoma. Resection of the extrahepatic bile duct was performed. Resected specimen showed nodular-type tumor at the left hepatic duct and its invasion to right hepatic duct. Histological examination revealed mucinous adenocarcinoma. This case indicated that resection of the involved segment of the liver and dilated bile duct on initial admission should be necessary because long-standing bile stasis and infection in dilated bile duct may induce the occurrence of carcinoma. 症例は70歳, 女性. 平成3年11月5日肝内結石症(IE型)および膵石症の診断にて, 胆嚢摘出, 総胆管切開切石およびTチューブドレナージ術, 膵石切石および膵管空腸側々吻合術を施行した. 術後, 遺残結石に対して胆道鏡下切石術を繰返し施行し, 肝内および肝外胆管の拡張は不変であったが, 完全切石を確認後退院した. 平成6年5月発熱食欲低下および右季肋部痛を認め, 経皮経肝的胆道ドレナージ術を施行した. 左右肝管合流部に陰影欠損を認め, 胆道鏡下生検にて腺癌と診断され, 肝門部胆管癌の診断で手術を施行した. 腫瘍は左肝管では結節状を呈し右肝管へと浸潤しており, 肉眼的形態分類は結節浸潤型で, 組織学的分類は粘液癌であった. 腹汁うっ滞や胆汁感染をきたすような拡張した胆管には, 癌腫の発生の可能性が考えられ, 初回手術時には肝切除に加えて, 拡張した胆管の切除も考慮すべきであると思われた. |
| Author | ISA, Tsutomu SHIRAISHI, Masayuki NAKACHI, Atsushi MATSUMOTO, Mitsuyuki YAMADA, Mamoru ICUSHI, Kazuaki KUSANO, Toshiomi TAMAI, Osamu NAKAMOTO, Takeru MUTO, Yoshihiro |
| Author_FL | 松本 光之 仲地 厚 中本 尊 久志 一朗 玉井 修 武藤 良弘 伊佐 勉 白石 祐之 山田 護 草野 敏臣 |
| Author_FL_xml | – sequence: 1 fullname: 伊佐 勉 – sequence: 2 fullname: 草野 敏臣 – sequence: 3 fullname: 中本 尊 – sequence: 4 fullname: 仲地 厚 – sequence: 5 fullname: 久志 一朗 – sequence: 6 fullname: 玉井 修 – sequence: 7 fullname: 白石 祐之 – sequence: 8 fullname: 松本 光之 – sequence: 9 fullname: 山田 護 – sequence: 10 fullname: 武藤 良弘 |
| Author_xml | – sequence: 1 fullname: MATSUMOTO, Mitsuyuki organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: SHIRAISHI, Masayuki organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: ISA, Tsutomu organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: MUTO, Yoshihiro organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: NAKAMOTO, Takeru organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: KUSANO, Toshiomi organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: ICUSHI, Kazuaki organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: NAKACHI, Atsushi organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: TAMAI, Osamu organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus – sequence: 1 fullname: YAMADA, Mamoru organization: The First Department of. Surgery, School of Medicine, Univerity of the Ryukyus |
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| References | 5) 呂 明徳, 宮崎耕治, 宮本和幸ほか: 肝内結石症完全載石13年後に発症した肝内胆管癌の1例. 胆と膵 10: 743-747, 1989 10) 高 済峯, 吉川周作, 畑芳樹ほか: 胆管癌と膵石を併存した先天性総胆管拡張症の1手術例. 日消外会誌 24: 1295-1299, 1991 1) 角田 司: 肝内胆管癌を合併した肝内結石症. 日消外会誌 23: 118-121, 1990 6) 川平洋一, 中尾量保, 濱路政靖ほか: 肝内結石症術後の5年目に発症した肝内胆管癌の1手術例. 日臨外医会誌 53: 1187-1191, 1992 2) 羽生富士夫, 中村光司, 竹田秀一ほか: 肝内結石症と胆管癌. 胆と膵 12: 405-416, 1991 7) 伊達和彦, 宮崎耕治, 一宮 仁ほか: 肝内結石症に続発した肝内體管癌の1例. 外科診療 30: 1275-1278, 1988 11) Chen MF, Jan YY, Wang CS, et al A reappraisal of cholangiocarcinoma in patient with hepatolithiasis. Cancer 71: 2461-2465, 1993 12) 中山和道, 木下寿文, 横溝清司ほか: 肝内結石症に対する治療方法の選択. 消化器外科 13: 437-444, 1990 4) Chijiwa K, Ichimiya H, Kuroki S, et al: Late development of cholangiocarcinoma after the treatm ent of hepatolithiasis. Surg Gynecol Obstet 177: 279-282, 1993 9) 金子哲也, 寺部啓介, 伊藤公一ほか: 膵胆管合流部異常に肝内結石, 膵石を伴った1例. 胆道 5: 568-572, 1991 8) 太田哲生, 永川宅和, 小西一朗ほか: 肝内結石症に合併した肝内胆管癌7例と肝内胆管腺腫1例の臨床病理学的検討. 日消外会誌 20: 748-753, 1987 3) 川原田嘉文, 三田孝行: 肝内結石症と肝内胆管癌. 胆と膵 15: 435-446, 1994 |
| References_xml | – reference: 8) 太田哲生, 永川宅和, 小西一朗ほか: 肝内結石症に合併した肝内胆管癌7例と肝内胆管腺腫1例の臨床病理学的検討. 日消外会誌 20: 748-753, 1987 – reference: 4) Chijiwa K, Ichimiya H, Kuroki S, et al: Late development of cholangiocarcinoma after the treatm ent of hepatolithiasis. Surg Gynecol Obstet 177: 279-282, 1993 – reference: 1) 角田 司: 肝内胆管癌を合併した肝内結石症. 日消外会誌 23: 118-121, 1990 – reference: 2) 羽生富士夫, 中村光司, 竹田秀一ほか: 肝内結石症と胆管癌. 胆と膵 12: 405-416, 1991 – reference: 7) 伊達和彦, 宮崎耕治, 一宮 仁ほか: 肝内結石症に続発した肝内體管癌の1例. 外科診療 30: 1275-1278, 1988 – reference: 6) 川平洋一, 中尾量保, 濱路政靖ほか: 肝内結石症術後の5年目に発症した肝内胆管癌の1手術例. 日臨外医会誌 53: 1187-1191, 1992 – reference: 10) 高 済峯, 吉川周作, 畑芳樹ほか: 胆管癌と膵石を併存した先天性総胆管拡張症の1手術例. 日消外会誌 24: 1295-1299, 1991 – reference: 12) 中山和道, 木下寿文, 横溝清司ほか: 肝内結石症に対する治療方法の選択. 消化器外科 13: 437-444, 1990 – reference: 3) 川原田嘉文, 三田孝行: 肝内結石症と肝内胆管癌. 胆と膵 15: 435-446, 1994 – reference: 9) 金子哲也, 寺部啓介, 伊藤公一ほか: 膵胆管合流部異常に肝内結石, 膵石を伴った1例. 胆道 5: 568-572, 1991 – reference: 11) Chen MF, Jan YY, Wang CS, et al A reappraisal of cholangiocarcinoma in patient with hepatolithiasis. Cancer 71: 2461-2465, 1993 – reference: 5) 呂 明徳, 宮崎耕治, 宮本和幸ほか: 肝内結石症完全載石13年後に発症した肝内胆管癌の1例. 胆と膵 10: 743-747, 1989 |
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| Title | A case of carcinoma of the hepatic hilus occuring 3 years after the operation for hepatolithiasis and pancreatolithiasis |
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