CT Evaluation of Disease Pattern in Hilar Cholangiocarcinoma

Abstract

Purpose: The objectives of our study were to map the various imaging patterns of hilar cholangiocarcinoma and identify commonest pattern. Material and methods:In this retrospective study a search of the case records of the hospital using the key word cholangiocarcinoma in hospital information system and morphology code M-8160/3 yielded 288 patients of cholangiocarcinoma in the period April 2001 to June 2016. One hundred and fifty nine patients of intrahepatic and distal cholangiocarcinoma were excluded. Out of the remaining 129 patients with diagnosis of hilar cholangiocarcinoma, nine patients were excluded because available records were not complete. The remaining 120 patients formed the study sample.Results: All the 120 (100%) patients showed dilated intrahepatic biliary radicals. Periductal-infiltrating tumor was present in 117 (97.50%) cases. According to Bismuth-Corlette classification on imaging, type I tumor was present in three (02.50%), type II in 13 (10.83%), type IIIa in 32 (26.66%), type IIIb in 39 (32.50%), and type IV in 33 (27.50%) patients. The involvement of adjacent liver parenchyma was present in 60 (50.00%) patients. Atrophy of a lobe was present in 75 (62.50%) patients. Portal vein was involved in 91 (75.83%) patients. These findings were common in mass-forming tumor.Conclusion: Diagnosis of this rare entity can be done on imaging by identifying its typical pattern. In the majority cases tumor appears to be centered on the right or left hepatic duct with involvement of the ipsilateral portal vein, atrophy of hepatic lobe on that side and invasion of adjacent liver parenchyma. Periductalinfiltrating tumor was commonest morphological form and type IIIb was the commonest pattern.

Future liver remnant hypertrophy rate in portal vein embolization before left trisectionectomy: a retrospective cohort study

“…PVE before left trisectionectomy involves the embolization of the left portal vein, which seems to be technically more difficult than the embolization of the right portal vein as per our experience. Additionally, hilar cholangiocarcinoma was reported to involve the left portal vein more frequently than the right portal vein [7], which corresponds to an occasional involvement of the left portal vein in patients undergoing PVE before left trisectionectomy [4]. It is not known whether portal vein invasion has an impact on the FLR hypertrophy effect of PVE.…”