Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 19 January 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Development of bile duct cancer and biliary-enteric drainage

A new study has assessed the late development of bile duct cancer in patients who have previously undergone biliary-enteric drainage for benign disease.

News image

fiogf49gjkf04

In patients with biliary-enteric drainage, reflux of intestinal contents into the bile duct may occur and cause cholangitis, which is regarded as the most serious complication of these procedures.

Two events suggested to favor the late onset of cholangiocarcinoma are lithiasis of the biliary tract and a previous biliary-enteric anastomosis.

In order to evaluate the correlation between biliary-surgical drainage and the late development of cholangiocarcinoma of the biliary tract, a study of consecutive patients attending the Department of Surgery at the Medical School of the University of Rome, Italy, has been conducted by Dr Adriano Tocchi and colleagues.

A total of 1003 patients were included in the 30-year study, which was concluded in 1997 and is reported in the journal Annals of Surgery.

The study examined patients undergoing 3 different procedures of biliary-enteric anastomosis. These were transduodenal sphincteroplasty, choledochoduodenostomy, and hepaticojejunostomy.

cholangiocarcinoma rates
- highest after choledochoduodenostomy
Annals of Surgery

In each case the postoperative clinical course and long-term outcome were evaluated by a retrospective review of the hospital records and follow-up. Mean follow-up was 129.6 months.

55 (5.5%) cases of primary bile duct cancer were found among the 1003 patients, at intervals of 132 to 218 months from biliary-enteric anastomosis.

The incidence of cholangiocarcinoma was found to be highest in patients undergoing choledochoduodenostomy, with 7.6% of this group developing cancer.

There was a lower risk of primary bile duct cancer in transduodenal sphincteroplasty patients (5.8%), and an even further reduced risk in hepaticojejunostomy patients (1.9%).

The incidence of malignancy related to the different underlying diagnosis was 5.9%, 7.2%, and 1.9% in patients with choledocholithiasis, sphincter of Oddi stenosis, and postoperative benign stricture, respectively.

Although only one patient who developed cholangiocarcinoma had previous concurrent lithiasis of the biliary tract, 40 patients had experienced mostly severe, recurrent cholangitis.

No case of malignancy occurred in patients scored as having no cholangitis in the early and long-term postoperative outcome.

Univariate and multivariate analyses indicated the presence of cholangitis as the only factor affecting the incidence of cholangiocarcinoma.

Dr Tocchi, speaking on behalf of his fellow authors, said the study showed that "chronic inflammatory changes consequent to biliary-enteric drainage should be closely monitored for the late development of biliary tract malignancies."

Ann Surg 2001; 234 (2): 210-214
27 August 2001

Go to top of page Email this page Email this page to a colleague

 19 January 2018 
Ileoanal pouch microbiota
 19 January 2018 
Predicting the risk of early surgery in Crohn’s
 19 January 2018 
Lifestyle intervention vs gastric bypass for obesity and diabetes
 18 January 2018 
Sleeve gastrectomy vs Roux-en-Y gastric bypass
 18 January 2018 
Healthcare costs of liver cancer in the USA
 18 January 2018 
High-risk adenomas at colonoscopy
 17 January 2018 
“Weekend effect” in upper GI hemorrhage
 17 January 2018 
Gut dysbiosis and non-antibiotic prescription medications
 17 January 2018 
Reducing surgical infections in high-outlier colorectal unit
 16 January 2018 
Bundle of care in GI cancer surgery
 16 January 2018 
Anxiety about colonoscopy
 16 January 2018 
Thiopurines and colorectal neoplasia in IBD
 15 January 2018 
Risks of death after liver transplants for liver cancer
 15 January 2018 
Recent advances in hepatocellular carcinoma
 15 January 2018 
Ileostomy output using telemedicine
 12 January 2018 
Surveillance protocols after colorectal cancer resection
 12 January 2018 
Biologic therapy by pregnant women with IBD and infant vaccines
 12 January 2018 
Biologic therapies for IBD in the USA
 11 January 2018 
Genetic risk factors in GERD
 11 January 2018 
Predictor of colorectal adenoma
 11 January 2018 
Ectopic pregnancy in IBD 
 10 January 2018 
Fecal immunochemical tests for colorectal cancer screening
 10 January 2018 
Risk factors for advanced NAFLD
 10 January 2018 
Dyspepsia prevalence with gastroesophageal reflux–type symptoms
 09 January 2018 
Screening intervals for people with family histories of colorectal cancer
 09 January 2018 
Financial impact of colorectal cancer
 09 January 2018 
Current practice and future research in autoimmune hepatitis
 08 January 2018 
Reliability of the IBD index
 08 January 2018 
Improving prognosis in patients with primary sclerosing cholangitis
 08 January 2018 
Aprepitant and nausea with gastroparesis
 05 January 2018 
Autoimmune pancreatitis and IBD
 05 January 2018 
Primary nonresponse to infliximab therapy
 05 January 2018 
Anesthesia assistance in outpatient colonoscopy
 04 January 2018 
Dietary polyphenols in the etiology of IBD
 04 January 2018 
Yoga vs low-FODMAP in IBS
 04 January 2018 
Local esophageal food allergen injections in eosinophilic esophagitis
 03 January 2018 
Population health management for IBD
 03 January 2018 
GERD in asthma and COPD
 03 January 2018 
Critical research gaps in colorectal cancer
 22 December 2017 
Costs of extrahepatic manifestations of Hep C
 22 December 2017 
Cholera vaccine and risk of death in colorectal cancer
 22 December 2017 
Colonoscopy after colorectal cancer resection
 21 December 2017 
Human oral microbiome and pancreatic cancer risk
 21 December 2017 
Health management for IBD
 21 December 2017 
PPI and Alzheimer's disease
 20 December 2017 
Management of abnormal liver blood tests
 20 December 2017 
Incidence of biopsy-verified celiac disease
 20 December 2017 
Osteoporotic fractures in Barrett's esophagus
 19 December 2017 
Alcohol abstinence and alcoholic hepatitis
 19 December 2017 
Family burden of pediatric Crohn's in the USA
 19 December 2017 
Early readmission in IBD patients
 18 December 2017 
Colorectal cancer mortality with low-risk adenomas at colonoscopy
 18 December 2017 
Disease activity indices in celiac disease
 18 December 2017 
Smoking behaviour predicted the risk of surgery in Crohn's
 15 December 2017 
Molecular classification of Crohn's disease
 15 December 2017 
Medical cannabinoid legalization policy and vomiting
 15 December 2017 
Inflammatory diet pattern and colorectal cancer risk
 14 December 2017 
PPIs and gastric cancer after H.pylori eradication
 14 December 2017 
H. pylori eradication therapies in countries with clarithromycin resistance
 13 December 2017 
Disease severity in NAFLD

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us