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Diagnostic dilemmas in biliary strictures mimicking cholangiocarcinoma.

Authors :
Principe A
Ercolani G
Bassi F
Paolucci U
Raspadori A
Turi P
Beltempo P
Grazi GL
Cavallari A
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