Incidence of benign lesions in patients resected for suspicious hilar obstruction

Background: The differentiation between benign and malignant strictures at the hepatic hilum is difficult. The aim of this study was to assess the clinical and radiographical features of hilar lesions in a series of patients resected for a presumed cholangiocarcinoma. Methods: Of 132 consecutive pat...

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Bibliographic Details
Published in:British journal of surgery 2001-01, Vol.88 (1), p.48-51
Main Authors: Gerhards, M. F., Vos, P., van Gulik, T. M., Rauws, E. A. J., Bosma, A., Gouma, D. J.
Format: Article
Language:English
Subjects:
Abdominal Pain - etiology
Adult
Aged
Bile Duct Neoplasms - diagnostic imaging
Bile Duct Neoplasms - pathology
Biological and medical sciences
Cholangiocarcinoma - diagnostic imaging
Cholangiocarcinoma - pathology
Cholangiopancreatography, Endoscopic Retrograde - methods
Female
Gastroenterology. Liver. Pancreas. Abdomen
Humans
Intraoperative Care - methods
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical sciences
Middle Aged
Neoplasm Staging - methods
Postoperative Care - methods
Preoperative Care - methods
Prognosis
Tomography, X-Ray Computed - methods
Tumors
Ultrasonography
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Summary:Background: The differentiation between benign and malignant strictures at the hepatic hilum is difficult. The aim of this study was to assess the clinical and radiographical features of hilar lesions in a series of patients resected for a presumed cholangiocarcinoma. Methods: Of 132 consecutive patients undergoing resection for a suspicious lesion at the hepatic hilum, 20 (15 per cent) had a histopathologically proven benign tumour, diagnosed as chronic fibrosing or erosive inflammation, sclerosing cholangitis, or a granular cell tumour. All medical files and radiological examinations of the patients were reassessed. Results: Clinical symptoms were considered suspicious in 16 of 19 patients. At ultrasonography only one of 16 patients had an unsuspicious examination. In 14 of 18 patients cholangiographic images were considered suspicious. Overall reassessment confirmed a suspicious lesion in all 20 patients. Conclusion: Because of the limitations of current diagnostic tools, a false‐positive preoperative diagnosis of malignancy resulted in a 15 per cent resection rate of benign lesions in this series of suspicious hilar strictures. © 2001 British Journal of Surgery Society Ltd
ISSN:0007-1323
1365-2168
DOI:10.1046/j.1365-2168.2001.01607.x