title: [Long-term survival in 2 cases with unresectable hilar bile duct cancer and sclerosing cholangitis].
abstract: Case 1: A 69-year-old man was admitted to a nearby clinic due to upper abdominal pain. Computed tomography revealed stenosis of the hilar bile duct and dilation of the intrahepatic bile duct in both lobes of the liver. A percutaneous transhepatic biliary drainage tube was inserted in the right anterior segment branch, and an endoscopic naso-biliary drainage tube was inserted in the left hepatic duct. He was referred to our hospital because of suspected hilar bile duct cancer. Radiographic examination showed severe stenosis of the hepatic hilar duct and tapering of the entire intrahepatic bile duct. The extent of invasion could not be evaluated and we concluded that the tumor was unresectable. Although systemic chemotherapy with gemcitabine was performed, the patient died at 37 months after the start of chemotherapy. Case 2: A 70- year-old woman was admitted to a nearby hospital due to epigastric pain and fever. Endoscopic retrograde cholangiopancreatography revealed stenosis of the hilar bile duct and a wide range of multiple stenosis in the intrahepatic bile duct. Bile cytology showed adenocarcinoma. Therefore, we decided the tumor was unresectable. Systemic chemotherapy with gemcitabine was started. She is in good health 57 months after the start of chemotherapy.
authors.affiliation: Dept. of Surgery, Kobe University Graduate School of Medicine, Japan.
authors.forename: Izuru
authors.initials: I
authors.lastname: Ohtsubo
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Ajiki
authors.forename: Taro
authors.initials: T
authors.lastname: Okazaki
authors.forename: Kenta
authors.initials: K
authors.lastname: Shinozaki
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yoshida
authors.forename: Sae
authors.initials: S
authors.lastname: Murakami
authors.forename: Makoto
authors.initials: M
authors.lastname: Shinzeki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kido
authors.forename: Ippei
authors.initials: I
authors.lastname: Matsumoto
authors.forename: Takumi
authors.initials: T
authors.lastname: Fukumoto
authors.forename: Yonson
authors.initials: Y
authors.lastname: Ku
mesh_terms: D000368:Aged; D000964:Antimetabolites, Antineoplastic / Q000627:therapeutic use*; D001650:Bile Duct Neoplasms / Q000150:complications / Q000188:drug therapy*; D015209:Cholangitis, Sclerosing / Q000209:etiology*; D003841:Deoxycytidine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male; D013997:Time Factors; D016896:Treatment Outcome; D000093542:Gemcitabine
chemical_list: D000964:Antimetabolites, Antineoplastic; D003841:Deoxycytidine; D000093542:Gemcitabine