Benign hilar bile duct strictures resected as perihilar cholangiocarcinoma

The British Journal of Surgery
S OtsukaM Nagino

Abstract

Differentiation between perihilar cholangiocarcinoma (PHCC) and benign strictures is frequently difficult. The aim of this study was to investigate the incidence and long-term outcome of patients with tumours resected because of suspicion of PHCC, which ultimately turned out to be benign (malignancy masquerade). Patients who underwent surgical resection with a diagnosis of PHCC between 2001 and 2016 were reviewed retrospectively. Among 707 consecutive patients, 685 had PHCC and the remaining 22 (3·1 per cent) had benign biliary stricture. All patients with benign disease underwent major hepatectomy, with no deaths. Preoperative histological assessment using bile duct biopsy or aspiration cytology had a high specificity (90 per cent), low sensitivity (62 per cent) and unsatisfactory accuracy (63 per cent). Despite the increasing use of histological assessment, the incidence of benign strictures resected did not decrease over time, being 0·9 per cent in 2001-2004, 4·0 per cent in 2005-2008, 3·8 per cent in 2009-2012 and 2·9 per cent in 2013-2016. The final pathology of benign strictures included IgG4-related sclerosing cholangitis (9 patients), hepatolithiasis (4), granulomatous cholangitis (3), non-specific chronic cholangitis (...Continue Reading

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Citations

Dec 4, 2019·Annals of Gastroenterological Surgery·Masato Nagino
May 6, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Anne-Marleen van KeulenPim B Olthof
May 28, 2021·World Journal of Gastrointestinal Oncology·Gianluca RompianesiRoberto Troisi

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