Precise mapping of hilar cholangiocarcinoma with a skip lesion by SpyGlass cholangioscopy:A case report  

作　　者：Cheng-Han Chiang Kuan-Chih Chen Benedict Devereaux Chen-Shuan Chung Kuei-Chang Kuo Chien Chu Lin Cheng-Kuan Lin Hsiu-Po Wang Kuo-Hsin Chen 

机构地区：[1]Division of Gastroenterology and Hepatology,Department of Internal Medicine,Xin-Tai General Hospital,New Taipei 242063,Taiwan [2]Department of Internal Medicine,Far Eastern Memorial Hospital,New Taipei 22060,Taiwan [3]Department of Gastroenterology,Royal Brisbane and Women's Hospital,Herston 4029,Queensland,Australia [4]Department of Internal Medicine,College of Medicine,National Taiwan University,Taipei 10002,Taiwan [5]Department of Surgery,Far Eastern Memorial Hospital,New Taipei 22060,Taiwan

出　　处：《World Journal of Gastrointestinal Surgery》2023年第5期965-971,共7页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Cholangiocarcinoma(CC)is a very aggressive cancer with a poor prognosis.As surgery is the only curative therapy,preoperative evaluation of the tumor extent is essential for surgical planning.Although high-quality image modalities such as computed tomography and magnetic resonance imaging have been used extensively in preoperative evaluation,the accuracy is low.To obtain precise localization of tumor spread arising from the hilar region preoperatively,the development of an acceptable imaging modality is still an unmet need.CASE SUMMARY A 52-year-old female presented to our emergency department with jaundice,abdominal pain,and fever.Initially,she was treated for cholangitis.Endoscopic retrograde cholangiopancreatography with the cholangiogram showed long segment filling defect in the common hepatic duct with dilatation of bilateral intrahepatic ducts.Transpapillary biopsy was performed,and the pathology suggested intraductal papillary neoplasm with high-grade dysplasia.After treatment of cholangitis,contrasted-enhanced computed tomography revealed a hilar lesion with undetermined Bismuth-Corlette classification.SpyGlass cholan gioscopy showed that the lesion involved the confluence of the common hepatic duct with one skip lesion in the posterior branch of the right intrahepatic duct,which was not detected by previous image modalities.The surgical plan was modified from extended left hepatectomy to extended right hepatectomy.The final diagnosis was hilar CC,pT2aN0M0.The patient has remained disease-free for more than 3 years.CONCLUSION SpyGlass cholangioscopy may have a role in precision localization of hilar CC to provide surgeons with more information before the operation.

关 键 词：Hilar cholangiocarcinoma JAUNDICE SpyGlass cholangioscopy Bismuth-Corlette classification HEPATECTOMY Case report 

分 类 号：R735.8[医药卫生—肿瘤]