Document Detail


Catheter tract recurrence after percutaneous biliary drainage for hilar cholangiocarcinoma.
MedLine Citation:
PMID:  23188530     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite its wide use, catheter tract recurrence after percutaneous biliary drainage (PBD) is rarely reported. However, one recent large-scale study reported a catheter tract recurrence rate as high as 5.2 % in patients with perihilar or distal bile duct cancer. We report on our 20 years of experience with catheter tract seeding after PBD for hilar cholangiocarcinoma.
METHODS: The medical records of 441 patients who underwent operation for hilar cholangiocarcinoma between 1991 and 2011 were retrospectively analyzed.
RESULTS: Of the 441 patients with hilar cholangiocarcinoma, PBD was performed in 315 patients, and 232 others underwent resection of hilar cholangiocarcinoma with PBD. Catheter tract recurrence developed in 6 patients (2.6 %). The median drainage duration was 30 days, and 1 patient had multiple PBDs. The median time to catheter recurrence after surgery was 10.9 months. Three patients underwent curative resection of the abdominal wall followed by chemotherapy, 1 patient underwent chemotherapy only, and 2 patients received conservative treatment. Five patients in whom the catheter tract recurrence was their first recurrence died of systemic recurrence at median 3.9 months after detection of catheter tract seeding. T1 or 2 disease (66.7 vs. 31.3 %; p = 0.086) tended to have catheter tract seeding with marginal significance. The overall survival rate was lower in patients with catheter tract seeding than in those without (median 17.5 vs. 23.0 months; p = 0.089).
CONCLUSIONS: The PBD catheter tract recurrence rate for hilar cholangiocarcinoma was 2.6 %. However, patients with catheter tract recurrence had a poor prognosis despite complete surgical metastasectomy.
Authors:
Mee Joo Kang; Yun-Suk Choi; Jin-Young Jang; In Woong Han; Sun-Whe Kim
Publication Detail:
Type:  Case Reports; Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  World journal of surgery     Volume:  37     ISSN:  1432-2323     ISO Abbreviation:  World J Surg     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-24     Completed Date:  2013-07-12     Revised Date:  2013-07-30    
Medline Journal Info:
Nlm Unique ID:  7704052     Medline TA:  World J Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  437-42     Citation Subset:  IM    
Affiliation:
Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine, 28 Yongon-dong, Chongno-gu, Seoul 110-744, South Korea. meejookang@gmail.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Bile Duct Neoplasms / mortality,  pathology*,  surgery,  therapy
Bile Ducts, Intrahepatic / pathology*,  surgery
Catheterization / adverse effects*
Cholangiocarcinoma / mortality,  secondary*,  surgery
Combined Modality Therapy
Drainage / adverse effects*,  methods
Female
Hepatectomy
Humans
Male
Middle Aged
Neoplasm Seeding*
Pancreaticoduodenectomy
Retrospective Studies
Risk Factors
Survival Rate
Treatment Outcome
Comments/Corrections
Comment In:
World J Surg. 2013 Jul;37(7):1745-6   [PMID:  23604343 ]
World J Surg. 2013 Jul;37(7):1743-4   [PMID:  23430001 ]

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