title: Intrahepatic cholangiocarcinoma associated with intrahepatic duct stones.
abstract: OBJECTIVE
  It has been well established that the long-term prognosis of intrahepatic duct stones (IHDS) is complicated by the late development of biliary cirrhosis with associated intrahepatic cholangiocarcinoma (IHCC). Despite recent improvements in imaging studies, accurate preoperative diagnosis of IHCC is difficult. Therefore, we attempted to elucidate the clinical features of patients with IHDS with IHCC.
  
  
  METHODS
  We reviewed 80 patients with IHDS and divided them into two groups. The DS group included 72 patients who had only IHDS. The second group was defined as the CC group and included eight patients who had IHDS and IHCC. For diagnosis of IHDS and confirmation of coexisting IHCC, patients underwent various radiological evaluations and additional laboratory tests, such as serum carbohydrate antigen 19-9 (CA 19-9).
  
  
  RESULTS
  There was no significant difference in the symptoms and stone characteristics between the two groups. For the CC group, liver resection was performed in four patients. Three patients underwent curative resection, but only one of these patients was alive at 36 months without recurrence.
  
  
  CONCLUSIONS
  IHCC with IHDS was difficult to diagnose in the early phase. Therefore, while performing diagnostic studies and surgery for IHDS, one should always consider the possibility of coexisting cholangiocarcinoma.
authors.affiliation: Department of Surgery, Holy Family Hospital, College of Medicine, The Catholic University of Korea, Gyeonggi-do, Korea.
authors.forename: Hoon
authors.initials: H
authors.lastname: Hur
authors.forename: Il-Young
authors.initials: IY
authors.lastname: Park
authors.forename: Gi-Young
authors.initials: GY
authors.lastname: Sung
authors.forename: Do-Sang
authors.initials: DS
authors.lastname: Lee
authors.forename: Wook
authors.initials: W
authors.lastname: Kim
authors.forename: Jong-Man
authors.initials: JM
authors.lastname: Won