De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis
Primary sclerosing cholangitis (PSC) is a chronic, progressive, inflammatory and obstructive disease of the intra-and extra-hepatic bile ducts of unknown etiology. Currently, orthotopic liver transplantation (OLT) is the only definitive treatment for PSC-related end-stage liver disease. However, PSC...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2009-10-01
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| Series: | Annals of Hepatology |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1665268119317545 |
| _version_ | 1828144753619763200 |
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| author | Carmen Landaverde Vivian Ng Alisa Sato James Tabibian Francisco Durazo Ronald Busuttil |
| author_facet | Carmen Landaverde Vivian Ng Alisa Sato James Tabibian Francisco Durazo Ronald Busuttil |
| author_sort | Carmen Landaverde |
| collection | DOAJ |
| description | Primary sclerosing cholangitis (PSC) is a chronic, progressive, inflammatory and obstructive disease of the intra-and extra-hepatic bile ducts of unknown etiology. Currently, orthotopic liver transplantation (OLT) is the only definitive treatment for PSC-related end-stage liver disease. However, PSC has been known to recur in the grafted liver. Roux-en-Y hepaticojejunostomy is more commonly performed than choledocho-choledochostomy for PSC, although choledochocholedochostomy has been found to be safe and efficacious for PSC if the distal common bile duct is uninvolved at the time of OLT. Our case is unique in that it describes a patient who developed de-novo cholangiocarcinoma in the remnant portion of the native common bile duct six years after OLT with choledochocholedochostomy for PSC-associated end-stage liver disease without having PSC recurrence. In conclusion, our case report indicates that choledochocholedochostomy may not be desirable in PSC due to an increased risk of developing cholangiocarcinoma in the native common bile duct. This risk exists as well with a Roux-en-Y hepaticojejunostomy in the remaining intra-duodenal and intra-pancreatic biliary epithelium, although in theory to a lesser extent. Therefore, the risk of developing cholangiocarcinoma in the recipient common bile duct can only be completely eliminated by performing a Whipple procedure at the time of OLT. |
| first_indexed | 2024-04-11T20:21:44Z |
| format | Article |
| id | doaj.art-886bf518570140e18c2be9475734c52e |
| institution | Directory Open Access Journal |
| issn | 1665-2681 |
| language | English |
| last_indexed | 2024-04-11T20:21:44Z |
| publishDate | 2009-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Annals of Hepatology |
| spelling | doaj.art-886bf518570140e18c2be9475734c52e2022-12-22T04:04:48ZengElsevierAnnals of Hepatology1665-26812009-10-0184379383De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitisCarmen Landaverde0Vivian Ng1Alisa Sato2James Tabibian3Francisco Durazo4Ronald Busuttil5University of California, Los Angeles, Department of MedicineUniversity of California, Los Angeles, Department of MedicineUniversity of California, Los Angeles, Department of MedicineUniversity of California, Los Angeles, Department of MedicineUniversity of California, Los Angeles, Department of Medicine; University of California, Los Angeles, Department of Surgery; Correspondence and reprint request:University of California, Los Angeles, Department of SurgeryPrimary sclerosing cholangitis (PSC) is a chronic, progressive, inflammatory and obstructive disease of the intra-and extra-hepatic bile ducts of unknown etiology. Currently, orthotopic liver transplantation (OLT) is the only definitive treatment for PSC-related end-stage liver disease. However, PSC has been known to recur in the grafted liver. Roux-en-Y hepaticojejunostomy is more commonly performed than choledocho-choledochostomy for PSC, although choledochocholedochostomy has been found to be safe and efficacious for PSC if the distal common bile duct is uninvolved at the time of OLT. Our case is unique in that it describes a patient who developed de-novo cholangiocarcinoma in the remnant portion of the native common bile duct six years after OLT with choledochocholedochostomy for PSC-associated end-stage liver disease without having PSC recurrence. In conclusion, our case report indicates that choledochocholedochostomy may not be desirable in PSC due to an increased risk of developing cholangiocarcinoma in the native common bile duct. This risk exists as well with a Roux-en-Y hepaticojejunostomy in the remaining intra-duodenal and intra-pancreatic biliary epithelium, although in theory to a lesser extent. Therefore, the risk of developing cholangiocarcinoma in the recipient common bile duct can only be completely eliminated by performing a Whipple procedure at the time of OLT.http://www.sciencedirect.com/science/article/pii/S1665268119317545Primary sclerosing cholangitisOrthotopic liver transplantationCholedochocholedochostomy |
| spellingShingle | Carmen Landaverde Vivian Ng Alisa Sato James Tabibian Francisco Durazo Ronald Busuttil De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis Annals of Hepatology Primary sclerosing cholangitis Orthotopic liver transplantation Choledochocholedochostomy |
| title | De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis |
| title_full | De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis |
| title_fullStr | De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis |
| title_full_unstemmed | De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis |
| title_short | De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis |
| title_sort | de novo cholangiocarcinoma in native common bile duct remnant following olt for primary sclerosing cholangitis |
| topic | Primary sclerosing cholangitis Orthotopic liver transplantation Choledochocholedochostomy |
| url | http://www.sciencedirect.com/science/article/pii/S1665268119317545 |
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