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Klatskin-mimicking lesions: still a diagnostical and therapeutical dilemma?
MedLine Citation:
PMID:  21661379     Owner:  NLM     Status:  In-Process    
BACKGROUND/AIMS: The preoperative as well as the intraoperative differentiation between Klatskin-mimicking lesions and malignant bile duct tumors at hilar bifurcation is still challenging. Our intention was to review the preoperative diagnostics including preoperative CA19-9 and bilirubin serum levels to compare benign and malignant tumors.
METHODOLOGY: We analyzed our prospectively established bile duct tumor database. From 1999 to 2008, 238 patients suspicious for hilar cholangiocarcinoma underwent surgery. In 24 patients the postoperative histological diagnosis showed a Klatskin-mimicking lesion. The histological report from 20 out of the 24 patients showed a chronic inflammatory transformation of the bile ducts. The histology of two patients showed a primary sclerosing cholangitis and the histological examination of the two remaining patients diagnosed a sarcoidosis of the extrahepatic bile duct.
RESULTS: Reassessment of preoperative diagnostics did not deliver any change of interpretation of the tumors' dignity compared to how it had been assessed preoperatively. Also, preoperative CA19-9 serum levels do not show a statistically reliable differentiation between benign or malignant dignity.
CONCLUSION: Current diagnostics cannot differentiate malignant from benign tumor masses in the hepatic hilum with the necessitated reliability. Therefore surgical resection of suspect hilar tumors is still the only appropriate therapy.
Benjamin Juntermanns; Gernot Maximilian Kaiser; Henning Reis; Fuat Hakan Saner; Sonia Radunz; Spiridon Vernadakis; Matthias Heuer; Hilmar Kuehl; Andreas Paul; Juergen Treckmann
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepato-gastroenterology     Volume:  58     ISSN:  0172-6390     ISO Abbreviation:  Hepatogastroenterology     Publication Date:    2011 Mar-Apr
Date Detail:
Created Date:  2011-06-13     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8007849     Medline TA:  Hepatogastroenterology     Country:  Greece    
Other Details:
Languages:  eng     Pagination:  265-9     Citation Subset:  IM    
Department of General, Visceral and Transplantation Surgery, University Hospital of Essen, Germany.
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