Patients with hepatolithiasis should be carefully followed up for detection of cholangiocarcinoma even after previous resection of liver segment or lobe

초록

Introduction The effect of liver segment or lobe resection on prevention of cholangiocarcinoma in hepatolithiasis patients is controversial. Here, we investigate the incidence of cholangiocarcinoma and its clinical characteristics from patients who were treated and followed up for hepatolithiasis with or without previous resection of liver segment or lobe. Patients and method From 2002 to 2009, we retrospectively reviewed 117 patients who were diagnosed and treated by hepatolithiasis in Guro Hospital, Korea University College of Medicine, Seoul, Korea. Among 117 patients, 55 patients who were lost during follow up were excluded, and 62 patients were eligible for analysis. The hepatic resection group (25) include patients who underwent lt. hemihepatectomy (2), lt. lateral segmentectomy (10), lt. lobectomy (5), Rt. lobectomy (3) and Wedge resection (1). And the non-hepatic resection group (37) include Transhepatic cholangiographic lithotomy and ERCP treated patients. Mean follow up period was 47 months. Result The incidence of cholangiocarcinoma while patients are being followed for hepatolithiasis was 12.9% (8/62) (hepatic resection group, 3 cases (12%) vs non-hepatic resection group, 5 cases (13.5%), p > 0.05). The mean follow-up period was 53 months (8∼110) until the diagnosis of cholangiocarcinoma. In hepatic resection group, 1 case showed cholangiocarcinoma arising from caudate lobe 8 months after lt. lobectomy, and 2 cases had cholangiocarcinoma 82 and 109 months after lt. lateral segmentectomy, at Rt. and lt. lobe respectively. As for 5 cases of non-hepatic resection group, cholangiocarcinoma occurred from the same place as the stone existed. Conclusion There was no difference in incidence of cholangiocarcinoma according to previous resection of liver segment or lobe. Patients with hepatolithiasis should be carefully followed up for detection of cholangiocarcinoma even after previous resection of liver segment or lobe.