[Burgeoning form of cancer of the superior biliary bifurcation Nosological, diagnostic and therapeutic aspects. Apropos of a case].
The authors report a case of fungating cholangiocarcinoma of the porta hepatis, revealed by jaundice in a 73-year-old cholecystectomized female. The diagnosis of obstruction of the hepatic duct junction suspected by ultrasonography and computed tomography was confirmed intraoperatively. Disobstruction was followed by laterolateral choledocoduodenostomy. An early recurrence required a second disobstruction with surgical then endoscopic insertion of a drain, with 23 months of satisfactory survival. The discussion is focused on hilar fungating cholangiocarcinoma. The extrahepatic (Klatskin tumor) or intrahepatic origin of these lesions, the circumstances and morphological investigations for the diagnosis are discussed. Particularities of the treatment are mentioned, with emphasis on the possible participation of the endoscopist for choledocho or hepaticoduodenostomy.
Solovei
G
G
Service de Chirurgie A, Hôpital Manchester, Charleville-Mezières.
Alame
A
A
Petit
J
J
Favriel
J M
JM
al Hareiss
H
H
Glavier
F
F
Cart
P
P
Fauchart
J P
JP
D002759:Adenoma, Bile Duct / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D000368:Aged; D000714:Anastomosis, Surgical; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D009364:Neoplasm Recurrence, Local; D019736:Prostheses and Implants; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography