title: Sclerosing cholangitis secondary to bleomycin-iodinated embolization for liver hemangioma.
abstract: Sclerosing cholangitis (SC) is a rarely reported morbidity secondary to transcatheter arterial chemoembolization (TACE) with bleomycin-iodinated oil (BIO) for liver cavernous hemangioma (LCH). This report retrospectively evaluated the diagnostic and therapeutic course of a patient with LDH who presented obstructive jaundice 6 years after TACE with BIO. Preoperative imaging identified a suspected malignant biliary stricture located at the convergence of the left and right hepatic ducts. Operative exploration demonstrated a full-thickness sclerosis of the hilar bile duct with right hepatic duct stricture and right lobe atrophy. Radical hepatic hilar resection with right-side hemihepatectomy and Roux-en-Y hepaticojejunostomy was performed because hilar cancer could not be excluded on frozen biopsy. Pathological results showed chronic pyogenic inflammation of the common and right hepatic ducts with SC in the portal area. Secondary SC is a long-term complication that may occur in LCH patients after TACE with BIO and must be differentiated from hilar malignancy. Hepatic duct plasty is a definitive but technically challenging treatment modality for secondary SC.
authors.affiliation: Shuo Jin, Xiao-Ju Shi, Xiao-Dong Sun, Guang-Yi Wang, Department of Hepatobiliary and Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Shuo
authors.initials: S
authors.lastname: Jin
authors.affiliation: Shuo Jin, Xiao-Ju Shi, Xiao-Dong Sun, Guang-Yi Wang, Department of Hepatobiliary and Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Xiao-Ju
authors.initials: XJ
authors.lastname: Shi
authors.affiliation: Shuo Jin, Xiao-Ju Shi, Xiao-Dong Sun, Guang-Yi Wang, Department of Hepatobiliary and Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Sun
authors.affiliation: Shuo Jin, Xiao-Ju Shi, Xiao-Dong Sun, Guang-Yi Wang, Department of Hepatobiliary and Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Si-Yuan
authors.initials: SY
authors.lastname: Wang
authors.affiliation: Shuo Jin, Xiao-Ju Shi, Xiao-Dong Sun, Guang-Yi Wang, Department of Hepatobiliary and Pancreatic Surgery, the First Norman Bethune Hospital Affiliated to Jilin University, Changchun 130021, Jilin Province, China.
authors.forename: Guang-Yi
authors.initials: GY
authors.lastname: Wang
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D000903:Antibiotics, Antineoplastic / Q000008:administration & dosage / Q000009:adverse effects*; D001650:Bile Duct Neoplasms / Q000175:diagnosis; D001706:Biopsy; D001761:Bleomycin / Q000008:administration & dosage / Q000009:adverse effects*; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D049448:Cholangiopancreatography, Magnetic Resonance; D015209:Cholangitis, Sclerosing / Q000139:chemically induced* / Q000175:diagnosis / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006392:Hemangioma, Cavernous / Q000628:therapy*; D006498:Hepatectomy; D006801:Humans; D007459:Iodized Oil / Q000009:adverse effects*; D041781:Jaundice, Obstructive / Q000139:chemically induced; D007582:Jejunostomy; D008113:Liver Neoplasms / Q000628:therapy*; D011237:Predictive Value of Tests; D013997:Time Factors; D014057:Tomography, X-Ray Computed
chemical_list: D000903:Antibiotics, Antineoplastic; D001761:Bleomycin; D007459:Iodized Oil
keywords: Bleomycin-iodinated oil; Definitive surgery; Differential diagnosis; Hilar stricture; Liver cavernous hemangioma; Sclerosing cholangitis; Secondary; Transcatheter arterial chemoembolization