Cholangiocarcinoma in the Distal Bile Duct: A Probable Etiologic Association with Choledocholithiasis

Nishimura, Masako; Naka, Shigeyuki; Hanazawa, Kazuyoshi; Tani, Toru; Fukami, M.; Okada, Shinta; Fujiyama, Yoshihide

doi:10.1007/s10620-005-3023-9

Cited by 7 publications

(4 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…3,40,44 Our study observed a previously unrecognized factor that may also be important in the pathogenesis of DCDBC: union of the cystic duct and common hepatic duct within the pancreas. In these cases, the cystic duct, rather than joining with the common hepatic duct just distal to the hepatic hilum, traveled separately toward the pancreas, entered it, and joined the common hepatic duct there, creating a short, entirely intrapancreatic CBD.…”

Section: Discussionmentioning

confidence: 60%

“…2,3 Accordingly, many studies dealing with the clinicopathologic aspects of DCBDC have been from Japan, 8,35–40 Korea, 41 and China. 9 Recently, certain groups in the United States have described and analyzed series of this entity as well.…”

Section: Discussionmentioning

confidence: 99%

“…2,3 While the World Health Organization uses the term “cholangiocarcinoma” only to refer to intrahepatic malignancies of biliary epithelial origin, 4 other authors have used the term to encompass extrahepatic bile duct adenocarcinomas as well. 5 These extrahepatic tumors have traditionally been divided into upper, middle, and lower categories, 5 though considering that middle bile duct tumors are rare and are often treated the same as either upper or lower tumors, some authors have advocated eliminating the category and designating cholangiocarcinomas as either intrahepatic, perihilar, or distal.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Intrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas

et al. 2016

View full text Add to dashboard Cite

Distal common bile duct carcinoma (DCBDC) is a poorly characterized entity, for reasons such as variable terminology and difficulty in determining site of origin of intrapancreatic lesions. We compared clinicopathologic features of pancreatobiliary-type adenocarcinomas within the pancreas but arising from the distal common bile duct (CBD) (defined as tumors centered around and circumferentially involving the intrapancreatic CBD) with those of pancreatic and ampullary origin. Upon careful review of 1017 pancreatoduodenectomy specimens with primary adenocarcinoma, 52 (5.1%) qualified as intrapancreatic DCBDC. Five associated with an intraductal papillary neoplasm were excluded; the remaining 47 were compared to 109 pancreatic ductal adenocarcinomas (PDAC) and 133 pancreatobiliary-type ampullary adenocarcinomas (AC). DCBDC patients had a younger median age (58 years) than PDAC patients (65 years) and AC patients (68 years). DCBDC was intermediate between PDAC and AC with regard to tumor size and rates of lymph node metastases and margin positivity. Median survival was better than for PDAC (P=0.0010) but worse than for AC (P=0.0006). Microscopically, DCBDC often formed an even band around the CBD and commonly showed intraglandular neutrophil-rich debris and a small tubular pattern. Poor prognostic indicators included lymph node metastasis (P=0.0010), lymphovascular invasion (P=0.0299), and margin positivity (P=0.0069). Categorizing the tumors based on size also had prognostic relevance (P=0.0096), unlike categorization based on anatomic structures invaded (P=0.1575). Primary DCBDC is seen in younger patients than PDAC or AC and has a prognosis significantly better than PDAC and worse than AC, at least partly due to differences in clinical presentation. Use of size-based criteria for staging appears to improve its prognostic relevance. When identified through careful dissection of pancreatoduodenectomy specimens, invasive pancreatobiliary-type DCBDC are uncommon in the West (5% of primary carcinomas in pancreatodudoenectomies) and have substantial clinicopathologic differences from their counterparts arising from the pancreas and ampulla.

show abstract

Section: Discussionmentioning

confidence: 60%

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Intrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas

et al. 2016

View full text Add to dashboard Cite

show abstract

“…Extrahepatic bile duct carcinomas were present in 7 of 143 patients (4.9%) with stones, which was significantly higher than the rate in the patients without stones (26 of 4339; 0.6%) ( P < 0.01). Nishimura et al [5] also reported the relationship between distal cholangiocarcinoma and cholidocholithiasis. The incidence of intrahepatic cholangiocarcinoma associated with hepatolithiasis as a risk factor has been reported to be 2.4–5.4% [6–8].…”

Section: Discussionmentioning

confidence: 99%

Diagnosis of Distal Cholangiocarcinoma after the Removal of Choledocholithiasis

Ito¹,

Kenmochi²,

Egawa³

et al. 2012

Gastroenterology Research and Practice

View full text Add to dashboard Cite

Background and Aim. Distal cholangiocarcinoma associated with choledocholithiasis has not been reported, and the causal relationship remains to be established. We evaluated diagnosis of distal cholangiocarcinoma diagnosed after the removal of choledocholithiasis. Patients and Methods. We assigned 9 cases of cholangiocarcinoma with choledocholithiasis to Group A. As a control group, 37 patients with cholangiocarcinoma without choledocholithiasis were assigned to Group B. Results. Abdominal pain at admission is the only significant difference between Group A and Group B (P = 0.001). All patients in Group A had gall bladder stones, compared with 7 patients (19%) in Group B (P < 0.01). Of the 9 patients in Group A, endoscopic retrade cholangiopancreatography (ERCP) detected normality in 2 patients (22%) and abnormalities in 7 patients (78%). Of the 32 patients in Group B, ERCP detected normality in 4 patients (13%) and abnormalities in 28 patients (88%) (P = 0.597). Intraductal ultrasonography (IDUS) detected a tumor in 8 patients in Group A, while in Group B, IDUS detected normality in 1 patient (3%) and tumors in 29 patients (97%) (P = 1.000). Conclusions. IDUS after stone removal may potentially help in the detection of unexpected tumors. Therefore, we believe that IDUS after stone removal will lead to improve outcome and prognosis.

show abstract

Extrahepatic Cholangiocarcinoma: Carcinoma of the Middle and Distal Common Bile Duct (Middle and Lower Bile Duct Carcinomas)

Zimmermann¹

2016

Tumors and Tumor-Like Lesions of the Hepatobiliary Tract

View full text Add to dashboard Cite

Cholangiocarcinoma in the Distal Bile Duct: A Probable Etiologic Association with Choledocholithiasis

Cited by 7 publications

References 21 publications

Intrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas

Intrapancreatic distal common bile duct carcinoma: Analysis, staging considerations, and comparison with pancreatic ductal and ampullary adenocarcinomas

Diagnosis of Distal Cholangiocarcinoma after the Removal of Choledocholithiasis

Extrahepatic Cholangiocarcinoma: Carcinoma of the Middle and Distal Common Bile Duct (Middle and Lower Bile Duct Carcinomas)

Contact Info

Product

Resources

About