Successful multidisciplinary treatment of hilar cholangiocarcinoma in a patient with complicated new-onset coronary artery disease.
We report a 69-year-old man suffering from hilar cholangiocarcinoma and concurrent new-onset complicated coronary artery disease. After implanting non-drug-eluting coronary stents, combination chemotherapy with gemcitabine and S-1 under continuation of dual antiplatelet therapy was carried out and partial tumour response was achieved. Subsequently, extended right hepatectomy with partial resection of the Spiegel lobe and left hepaticojejunostomy was performed while continuing preoperative single antiplatelet therapy with aspirin. The patient recovered well without any thromboembolic or bleeding complications. Like the current case, neoadjuvant chemotherapy and subsequent curative resection under continuation of antiplatelet therapy, followed by preceding coronary intervention, is one of the preferred options for the treatment of hepatobiliary malignancy in patients with concurrent new-onset coronary artery disease.
Department of Surgery, Kokura Memorial Hospital, Kitakyushu, Japan.
Takahisa
T
Fujikawa
Akira
A
Tanaka
D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001241:Aspirin / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D017024:Chemotherapy, Adjuvant; D018281:Cholangiocarcinoma / Q000150:complications* / Q000628:therapy*; D000077144:Clopidogrel; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications* / Q000628:therapy*; D006498:Hepatectomy; D006801:Humans; D007582:Jejunostomy; D008297:Male; D020360:Neoadjuvant Therapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D015607:Stents; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin