title: Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage (PTBD) for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature.
  
  
  METHODS
  A retrospective analysis of 67 consecutive patients who underwent PTBD before the resection of extrahepatic cholangiocarcinoma was conducted. The median follow-up period after PTBD was 106 mo. The English language literature (PubMed, National Library of Medicine, Bethesda, MD, USA), from January 1966 through December 2004, was reviewed.
  
  
  RESULTS
  Catheter tract implantation metastasis developed in three patients. The cumulative incidence of implantation metastasis reached a plateau (6%) at 20 mo after PTBD. All of the three patients with implantation metastasis died of tumor progression at 3, 9, and 20 mo after the detection of this complication. Among the 10 reported patients with catheter tract implantation metastasis from extrahepatic cholangiocarcinoma (including our three patients), two survived for more than 5 years after the excision of isolated catheter tract metastases.
  
  
  CONCLUSIONS
  Catheter tract implantation metastasis is not a rare complication following PTBD for extrahepatic cholangiocarcinoma. Although the prognosis for patients with this complication is generally poor, the excision of the catheter tract may enable survival in selected patients with isolated metastases along the catheter tract.
authors.affiliation: Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Sakata
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Shirai
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Wakai
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Nomura
authors.forename: Eiko
authors.initials: E
authors.lastname: Sakata
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Hatakeyama
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery; D001662:Biliary Tract Surgical Procedures; D002408:Catheters, Indwelling; D018281:Cholangiocarcinoma / Q000473:pathology / Q000601:surgery; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009366:Neoplasm Seeding; D012189:Retrospective Studies; D012196:Review Literature as Topic; D015996:Survival Rate; D016896:Treatment Outcome