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Diagnostic dilemmas in biliary strictures mimicking cholangiocarcinoma.
- Source :
-
Hepato-gastroenterology [Hepatogastroenterology] 2003 Sep-Oct; Vol. 50 (53), pp. 1246-9. - Publication Year :
- 2003
-
Abstract
- Background/aims: Bile duct strictures may be malignant or benign. In the absence of previous biliary surgery a precise preoperative diagnosis is often difficult, in particular when a tumor mass is absent in the preoperative radiologic findings.<br />Methodology: A review of 179 patients observed between 1982 and 2001 by the same surgical team with a preoperative diagnosis of malignant stricture of the biliary tree. A surgical procedure was performed in 153 of these cases.<br />Results: The presence of a malignant stricture was confirmed by final pathologic examination in 32 of 38 cases (96%) in which a curative resection was performed. A final diagnosis of inflammatory stricture secondary to choledocholithiasis was made in 3 of the remaining 6 cases (4%), along with one case each of sclerosing cholangitis, granular cell tumor and Mirizzi's syndrome, respectively.<br />Conclusions: Precise preoperative evaluation of biliary structures can be very difficult when a tumor mass is absent. Despite the use of invasive procedures and new techniques such as magnetic resonance cholangiopancreatography, a false-positive rate of 4% may be expected. However, whenever a malignancy is not definitely excluded, biliary strictures should be treated as a cholangiocarcinoma.
Details
- Language :
- English
- ISSN :
- 0172-6390
- Volume :
- 50
- Issue :
- 53
- Database :
- MEDLINE
- Journal :
- Hepato-gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 14571710