담석을 동반한 간내 담관암과 담석을 동반하지 않은 담관암의 임상적 비교 = Intrahepatic Cholangiocarcinoma Associated with Hepatolithiasis vs. Intrahepatic Cholangiocarcinoma Alone

다국어 초록 (Multilingual Abstract)

Background/Aim: Hepatolithiasis are very common in Korea and hepatolithiasis is a risk factor for cholangiocarcinoma. The differences of clinical, laboratory or radiological features between intrahepatic cholangiocarcinoma associated with hepatolithiasis and cholaniocar-cinoma alone does not well known until now. Author performed this study to define the clinical, laboratory or radiological differences between intrahepatic cholangiocarcinoma associated with hepatolithiasis and cholangiocarcinoma alone.
Methods: Sixty-one patients with intrahepatic cholangiocarcinoma associated with or without hepatolithiasis were analyzed retrospectively. There were 32 patients with cholangiocarcinoma associated with intraheaptic stones (group HC) and 29 cholangiocarcinoma patients without intraheaptic stones (group C). In group HC, there were 21 males and 11 females with a mean age of 63.4 years. Group C contained 17 males and 12 females with a mean age of 61.9 years.
Results: Patients with cholangiocarcinoma associated with intrahepatic stones had a significantly longer duration of symptoms, a higher frequency of biliary surgery than cholangiocarcinoma alone. In group HC, the main symptoms were abdominal pain, fever, chilling, and jaundice. In group C, the main symptoms were abdominal pain and jaundice. Concordance rate of location of stones and tumor was closely related in 96% of patients with cholangiocarcinoma and hepatolithiasis. Segmental stricture and dilated intrahepatic ducts were the most common radiological features of both groups. Tumor mass observed on the imaging study was encountered significantly frequent in the group C (82% vs. 53%, p<0.05). However, hepatic atrophy was noted more frequent in the group HC than group C (46% vs. 10%, p<0.05). There were no statistical differences between the two groups in the laboratory findings such as liver function test or tumor marker. Preoperative diagnostic rate of cholangiocarcinoma was lower in group HC than group C (78.2% vs. 96.6%).
Conclusion: If bile duct stricture or hepatic atrophy are noted in patients with intrahepatic stones, active effort for detection of concomitant cholangiocarcinoma will be needed.