title: Diagnosis and cure experience of hepatolithiasis-associated intrahepatic cholangiocarcinoma in 66 patients.
abstract: BACKGROUND
  The management of hepatolithiasis combined with intrahepatic cholangicarcinoma (IHHCC) remains a challenge due to poor prognosis. The aim of this study was to summarize our diagnosis and cure experience of IHHCC over the recent 10 years.
  
  
  METHODS
  From January 1996 to January 2006, 66 patients with IHHCC were reviewed retrospectively.
  
  
  RESULTS
  Of the 66 patients, 52 underwent surgical resection (radical resection in 38 and palliative in 14) and 8 patients abdominal exploration, while the other 6 cases received endoscopic retrograde biliary internal drainage and stent implantation. In this series, correct diagnosis of advanced stage was made during operation in 8 cases (8/60, 13.3%) and all of them (underwent unnecessary abdominal exploration, among them the positive rate of CA19-9 was 100%, and the positive rate of CEA was 87.6% (7/8), incidence rate of ascites was 100% and short-term significant weight loss was 100%, with median overall survival of only 4 months.
  
  
  CONCLUSIONS
  Radical resection is mandatory for IHHCC patient to achieve long-term survival, the CT and MR imaging features of IHHCC being concentric enhancement. Patients with IHHCC have significant higher CA199 and significant higher CEA and short-term significant weight loss and ascites should be considered with advanced stage of IHHCC and unnecessary non-therapeutic laparotomies should be avoided.
authors.affiliation: Department of Hepatobiliary Surgery, the Second Affiliated Hospital, Chongqing University of Medical Sciences, Chongqing, China.
authors.forename: Hong-Yang
authors.initials: HY
authors.lastname: Li
authors.forename: Shi-Ji
authors.initials: SJ
authors.lastname: Zhou
authors.forename: Min
authors.initials: M
authors.lastname: Li
authors.forename: Ding
authors.initials: D
authors.lastname: Xiong
authors.forename: Akanand
authors.initials: A
authors.lastname: Singh
authors.forename: Qing-Xi
authors.initials: QX
authors.lastname: Guo
authors.forename: Chang-An
authors.initials: CA
authors.lastname: Liu
authors.forename: Jian-Ping
authors.initials: JP
authors.lastname: Gong
mesh_terms: D001650:Bile Duct Neoplasms; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D004322:Drainage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D020347:Lithiasis / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015607:Stents; D015996:Survival Rate