Chemotherapy-induced sclerosing cholangitis as a rare indication for resection: report of a case.
Bile duct stricture due to chemotherapy-induced sclerosing cholangitis (CISC) is a potentially fatal complication of hepatic arterial infusion chemotherapy (HAIC). It is managed primarily with medical treatment and biliary stenting. We report a rare case of a CISC-related biliary stricture requiring resection. The patient had been receiving adjuvant HAIC for 11 months after a curative liver resection for hepatocellular carcinoma, when clinically overt cholangitis developed. Radiologic and biopsy findings suggested a CISC-related biliary stricture limited to the common hepatic duct. We discontinued HAIC and started corticosteroid treatment, which finally became ineffective. Endoscopic biliary stenting was impossible because of her severe biliary sclerosis, necessitating resection of the stricture, which was confirmed histologically to be secondary sclerosing cholangitis. The patient has shown no signs of recurrent cholangitis for 12 postoperative months since her operation. Thus, resection could be a treatment option for a CISC-related biliary stricture in selected patients.
Department of Surgery, International University of Health and Welfare, Mita Hospital, 1-4-3 Mita, Minato-ku, Tokyo 108-8329, Japan.
Yutaro
Y
Kato
Kentaro
K
Matsubara
Yoshinobu
Y
Akiyama
Hiroaki
H
Hattori
Akira
A
Hirata
Fumio
F
Suzuki
Hitoshi
H
Ohtaka
Ayu
A
Kato
Yoshiaki
Y
Sugiura
Masaki
M
Kitajima
D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000188:drug therapy; D015209:Cholangitis, Sclerosing / Q000139:chemically induced* / Q000601:surgery*; D005260:Female; D006801:Humans; D007261:Infusions, Intra-Arterial; D008113:Liver Neoplasms / Q000188:drug therapy; D008875:Middle Aged