Characteristics of Bile Duct Carcinoma with Superficial Extension in the Epithelium

Nanashima, Atsushi; Sumida, Yorihisa; Tobinaga, Syuuichi; Abo, Takafumi; Takeshita, Hiroaki; Sawai, Terumitsu; Hidaka, Shigekazu; Fukuoka, Hidetoshi; Nagayasu, Takeshi

doi:10.1007/s00268-009-9993-6

Cited by 5 publications

(5 citation statements)

References 31 publications

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“…As the previous reports showed that IPNB potentially had lower malignancy or invasiveness (7,9,15,18,22,28,35), less-invasive findings such as vessel infiltrations, depth of invasion, surrounding stromal invasion, and nodal metastasis in IPNB were significant in comparison with PAC in the present study. Regarding superficial extension of the main tumor, this characteristic was significantly more frequent in the papillary-type cholangiocarcinoma compared to the nodular or flat-type carcinomas in the previous reports and in our report (7,27,36). Okamoto et al examined the characteristics of papillary carcinomas, finding superficial extension in 53%, multicentric carcinogenesis, pancreatco-biliary maljunction, and a survival benefit for clearance by surgical resection (36).…”

Section: Discussionsupporting

confidence: 61%

“…Our previous reports identified the various tumor morphologies of IPNB, good prognosis, and difficulty in comparison with similar biliary tumors (19,(24)(25)(26). The significance of protruding bile duct carcinoma accompanied by widely superficial extension was also reported as characteristics in common with IPNB (27). However, PAC also has characteristics similar to IPNB (28).…”

Section: Discussionmentioning

confidence: 98%

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Clinicopathological Aspects and Diagnostic Problems in Patients with Intraductal Papillary Neoplasm of the Bile Duct

Nanashima

Imamura

Sumida

et al. 2018

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Section: Discussionsupporting

confidence: 61%

Section: Discussionmentioning

confidence: 98%

Clinicopathological Aspects and Diagnostic Problems in Patients with Intraductal Papillary Neoplasm of the Bile Duct

Nanashima

Imamura

Sumida

et al. 2018

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“…It is quite plausible that HGD/CIS at the margins might correspond to peripheral parts of the above‐mentioned intraepithelial neoplasia without underlying infiltrating carcinoma (high‐grade BilIN) around CCA. There have been several reports of extensive spreading of CIS in CCA cases 30,31 . In the present study, 10 of 54 CCAs with high‐grade BilIN showed marked spreading of intraepithelial neoplasms in the surrounding bile duct mucosa.…”

Section: Discussionsupporting

confidence: 54%

“…There have been several reports of extensive spreading of CIS in CCA cases. 30,31 In the present study, 10 of 54 CCAs with highgrade BilIN showed marked spreading of intraepithelial neoplasms in the surrounding bile duct mucosa. Taken together, these findings suggest that HGD/CIS at the bile duct margin is actually part of a high-grade BilIN with variable superficial mucosal extension from which CCA might have developed.…”

Section: Monthssupporting

confidence: 51%

Pathological survey of precursor lesions in cholangiocarcinoma

Nakanuma

Sugino

Kakuda

et al. 2023

J Hepato Biliary Pancreat

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Background To clarify the pathological significance of two precursors (high‐grade biliary intraepithelial neoplasm [BilIN] and intraductal papillary neoplasm of bile duct [IPNB]) in cholangiocarcinomas (CCAs). Methods Ninety‐one cases of CCA (47 distal CCAs [dCCAs], 31 perihilar CCAs [pCCAs] and 13 intrahepatic CCAs of large duct type [LD‐iCCAs]) were examined for their association with precursors. Neoplastic intraepithelial lesions without underlying infiltrating carcinoma in the surrounding mucosa of CCAs were considered to reflect high‐grade BilIN. High‐grade BilIN and IPNB were subdivided into gastric, biliary, intestinal and oncocytic subtypes, while CCAs were subdivided into gastrobiliary, intestinal and oncocytic subtypes. The postoperative overall survival (OS) was examined. Results Fifty‐four and 8 of 91 CCAs were associated with high‐grade BilIN and IPNB, respectively, while these precursors were unidentifiable in the remaining CCAs. A majority of CCAs were of the gastrobiliary subtype, while the intestinal subtype was occasionally detected, and the oncocytic subtype was rare. CCAs with high‐grade BilIN showed a similar postoperative OS to CCAs without precursors, while CCAs with IPNB showed a favorable postoperative OS compared to CCAs without precursors. Conclusions CCAs were frequently associated with precursors; high‐grade BilIN may be a major precursor and IPNB a minor one. CCAs with IPNB showed a favorable postoperative OS compared to CCAs with high‐grade BilIN.

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“…The average duration ranged from 60 to 120 min depending on the complexity. [16,17]. With the use of minimally invasive options, the average postoperative stay has substantially decreased.…”

Section: Introductionmentioning

confidence: 99%

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.

Al-Shehari,

Obadiel,

Al-Hubaishi

et al. 2024

jchm

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Background: Obstructive jaundice is among the most challenging conditions managed by general surgeons and significantly contributes to high morbidity and mortality. Objectives: This study evaluated the short-term outcomes of surgical treatment for benign obstructive jaundice. Methods: A cross-sectional descriptive study was conducted prospectively at Al-Thawra Modern General Hospital between January 2019 and December 2021, including all patients with benign obstructive jaundice who underwent open surgical treatment. Results: The study included 36 patients with a median age of 55 years, and female predominance (63.9%) compared with male predominance (36.1%). The most common preoperative diagnosis was common bile duct stones (66.7%), followed by postcholecystectomy biliary strictures (25%). Abdominal pain (91.7%) and jaundice (83.3%) were the most frequent symptoms. Twenty-four patients with CBD stones underwent cholecystectomy with CBD exploration with either T-tube drainage (17 patients) or choledochoduodenostomy drainage (5 patients), and only two patients underwent cholecystostomy tube drainage. However, all 9 patients with postcholecystectomy biliary strictures underwent hepaticoenterostomy drainage procedures. Postoperatively, the median length of hospital stay was 6.33 (2-15) days, and direct bilirubin levels decreased in most patients by the 7th day (88.9%). Wound infection (27.8%), mild pulmonary complications (19.4%), and moderate pulmonary complications requiring ICU admission (13.9%) were the most common complications. No mortality was recorded. Conclusions: Open surgical treatment of benign obstructive jaundice is safe and effective because improved abdominal pain, subsidence of obstructive jaundice features, and postoperative bilirubin level drop were observed in almost all patients. Wound infection and pulmonary complications were the most common complications. Common bile duct stones were the leading cause of this condition, and female preponderance was observed. Future studies should focus on optimizing the management of these patients, including minimizing postoperative complications such as wound infections.

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Characteristics of Bile Duct Carcinoma with Superficial Extension in the Epithelium

Cited by 5 publications

References 31 publications

Clinicopathological Aspects and Diagnostic Problems in Patients with Intraductal Papillary Neoplasm of the Bile Duct

Clinicopathological Aspects and Diagnostic Problems in Patients with Intraductal Papillary Neoplasm of the Bile Duct

Pathological survey of precursor lesions in cholangiocarcinoma

Short-term Outcomes of Surgical Treatment of Benign Obstructive Jaundice, Sana'a, Yemen.

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