职业性胆管癌切除术后的结果。

Outcomes after resection of occupational cholangiocarcinoma.

作者信息

Kubo Shoji, Takemura Shigekazu, Tanaka Shogo, Shinkawa Hiroji, Kinoshita Masahiko, Hamano Genya, Ito Tokuji, Koda Masaki, Aota Takanori, Yamamoto Takatsugu, Terajima Hiroaki, Tachiyama Gorou, Yamada Terumasa, Nakamori Shoji, Arimoto Akira, Fujikawa Masahiro, Tomimaru Yoshito, Sugawara Yasuhiko, Nakagawa Kei, Unno Michiaki, Mizuguchi Toru, Takenaka Kenji, Kimura Koichi, Shirabe Ken, Saiura Akio, Uesaka Katsuhiko, Taniguchi Hiroki, Fukuda Akira, Chong Ja-Mun, Kuwae Yuko, Ohsawa Masahiko, Sato Yasunori, Nakanuma Yasuni

机构信息

Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

Department of Surgery, Ishikiriseiki Hospital, Higashi-osaka, Japan.

出版信息

J Hepatobiliary Pancreat Sci. 2016 Sep;23(9):556-64. doi: 10.1002/jhbp.373. Epub 2016 Aug 1.

DOI:10.1002/jhbp.373

PMID:27363864

Abstract

BACKGROUND

Cholangiocarcinoma caused by exposure to 1,2-dichloropropane and/or dichloromethane is recognized as occupational cholangiocarcinoma. The aim of this study was to investigate the outcomes after resection of occupational cholangiocarcinoma to establish a treatment strategy for this disease.

METHODS

Clinicopathological findings and outcomes after surgical intervention in 20 patients with occupational cholangiocarcinoma were investigated.

RESULTS

Of 20 the patients, curative resection was performed in 16 patients. Three patients underwent radiation at the stump of the bile ducts. Adjuvant chemotherapy was performed in 12 patients. Biliary intraepithelial neoplasia, intraductal papillary neoplasm of the bile duct, and/or chronic bile duct injury was detected in most subjects. Intraabdominal infection developed after surgery in nine patients. Cholangiocarcinoma recurred in 12 of the 20 patients. The recurrent tumors in five patients developed at a different part of the bile duct from the primary tumor and a second resection was performed in four of these five patients.

CONCLUSIONS

The incidence of postoperative complications including intraabdominal infection was high in patients with occupational cholangiocarcinoma. Multicentric recurrence occurred not infrequently after surgery because the bile ducts had a high potential for the development of carcinoma. The aggressive treatment including second resection for the multicentric recurrence appeared to be effective.

摘要