Assessment of the biliary branching pattern of the caudate lobe in perihilar cholangiocarcinoma using ENBD-CT cholangiography.
ENBD
caudate lobe
cholangiography
perihilar cholangiocarcinoma
Journal
Journal of hepato-biliary-pancreatic sciences
ISSN: 1868-6982
Titre abrégé: J Hepatobiliary Pancreat Sci
Pays: Japan
ID NLM: 101528587
Informations de publication
Date de publication:
29 Sep 2024
29 Sep 2024
Historique:
medline:
30
9
2024
pubmed:
30
9
2024
entrez:
29
9
2024
Statut:
aheadofprint
Résumé
Preoperative recognition of the anatomy of caudate biliary branches is important for the safe and complete resection of perihilar cholangiocarcinoma (PHC). In the present study, we identified these branches using an endoscopic nasobiliary drainage tube (ENBD). Between January 2012 and October 2022, 89 patients with suspected PHC underwent computed tomographic (CT) cholangiography through ENBD and caudate biliary branching patterns were examined. Multidetector raw CT (MDCT) scans on 85 patients with PHC without biliary drainage were also investigated. The caudate biliary branches detected by each modality were evaluated. ENBD-CT cholangiography detected 206 caudate branches (2.44 branches/patient), while MDCT identified 62 branches (0.78 branches/patient). ENBD-CT cholangiography showed that 89 caudate branches drained into the left hepatic duct (LHD), 87 into the posterior hepatic duct (Bpost), and 30 into the right hepatic duct. LHD and Bpost were the common roots of the caudate branches. Some branches (20%) joined the contralateral hepatic duct across the left-right border, but not the anterior hepatic duct or infraportal-type Bpost. ENBD-CT cholangiography clearly showed the caudate biliary branches in patients with PHC after biliary drainage.
Sections du résumé
BACKGROUND
BACKGROUND
Preoperative recognition of the anatomy of caudate biliary branches is important for the safe and complete resection of perihilar cholangiocarcinoma (PHC). In the present study, we identified these branches using an endoscopic nasobiliary drainage tube (ENBD).
METHODS
METHODS
Between January 2012 and October 2022, 89 patients with suspected PHC underwent computed tomographic (CT) cholangiography through ENBD and caudate biliary branching patterns were examined. Multidetector raw CT (MDCT) scans on 85 patients with PHC without biliary drainage were also investigated. The caudate biliary branches detected by each modality were evaluated.
RESULTS
RESULTS
ENBD-CT cholangiography detected 206 caudate branches (2.44 branches/patient), while MDCT identified 62 branches (0.78 branches/patient). ENBD-CT cholangiography showed that 89 caudate branches drained into the left hepatic duct (LHD), 87 into the posterior hepatic duct (Bpost), and 30 into the right hepatic duct. LHD and Bpost were the common roots of the caudate branches. Some branches (20%) joined the contralateral hepatic duct across the left-right border, but not the anterior hepatic duct or infraportal-type Bpost.
CONCLUSIONS
CONCLUSIONS
ENBD-CT cholangiography clearly showed the caudate biliary branches in patients with PHC after biliary drainage.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
© 2024 Japanese Society of Hepato‐Biliary‐Pancreatic Surgery.
Références
Mueller M, Breuer E, Mizuno T, Bartsch F, Ratti F, Benzing C, et al. Perihilar cholangiocarcinoma ‐ novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann Surg. 2021;274:780–788.
Komaya K, Ebata T, Yokoyama Y, Igami T, Sugawara G, Mizuno T, et al. Recurrence after curative‐intent resection of perihilar cholangiocarcinoma: analysis of a large cohort with a close postoperative follow‐up approach. Surgery. 2018;163:732–738.
Higuchi R, Yazawa T, Uemura S, Izumo W, Furukawa T, Yamamoto M. High‐grade dysplasia/carcinoma in situ of the bile duct margin in patients with surgically resected node‐negative perihilar cholangiocarcinoma is associated with poor survival: a retrospective study. J Hepatobiliary Pancreat Sci. 2017;24:456–465.
Sanchez LI, Lamarca A, Casta AL, Buettner S, Utpatel K, Klümpen HJ, et al. Cholangiocarcinoma landscape in Europe: diagnostic, prognostic and therapeutic insights from the ENSCCA registry. J Hepatol. 2022;76:1109–1121.
Ohtsuka M, Miyakawa S, Nagino M, Takada T, Miyazaki M. Revision concepts and distinctive points of the new Japanese classification for biliary tract cancers in comparison with the 7(th) edition of the Union for International Cancer Control and the American joint committee on cancer staging system. J Hepatobiliary Pancreat Sci. 2015;22:197–201.
Nimura Y, Hayakawa N, Kamiya J, Kondo S, Shionoya S. Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus. World J Surg. 1990;14:535–543.
Shimada H, Endo I, Sugita M, Masunari H, Fujii Y, Tanaka K, et al. Is parenchyma‐preserving hepatectomy a noble option in the surgical treatment for high‐risk patients with hilar bile duct cancer? Langenbeck's Arch Surg. 2003;388:33–41.
Noji T, Tsuchikawa T, Okamura K, Shichinohe T, Tanaka E, Hirano S. Surgical outcome of hilar plate resection: extended hilar bile duct resection without hepatectomy. J Gastrointest Surg. 2014;18:1131–1137.
Onoe S, Mizuno T, Watanabe N, Yokoyama Y, Tsuyoshi Igami T, Yamaguchi J, et al. Utility of modified pancreaticoduodenectomy (hi‐cut PD) for middle‐third cholangiocarcinoma: an alternative to hepatopancreaticoduodenectomy. HPB (Oxford). 2024;26:530–540.
Kumon M. Anatomical study of the caudate lobe with special reference to portal venous and biliary branches using corrosion liver casts and clinical application. Liver Cancer. 2017;6:161–170.
Takamatsu S, Goseki N, Nakajima K, Teramoto K, Iwai T, Arii S. Distributing pattern of the bile duct of the caudate lobe on computed tomography with drip infusion cholangiography and its surgical significance. Hepato‐Gastroenterology. 2004;51:29–32.
Kitami M, Murakami G, Ko S, Takase K, Tuboi M, Saito H, et al. Spiegel's lobe bile ducts often drain into the right hepatic duct or its branches: study using drip‐infusion cholangiography‐computed tomography in 179 consecutive patients. World J Surg. 2004;28:1001–1006.
Edo H, Sekiguchi R, Edo N, Kajiyama A, Nagamoto M, Gomi T. Evaluation of biliary anatomy in the caudate lobe using drip infusion cholangiography‐computed tomography. Abdom Radiol (NY). 2019;44:886–893.
Furukawa H, Sano K, Kosuge T, Shimada K, Yamamoto J, Ishii H, et al. Analysis of biliary drainage in the caudate lobe of the liver: comparison of three‐dimensional CT cholangiography and rotating cine cholangiography. Radiology. 1997;204:113–117.
Sasaki R, Kondo T, Oda T, Murata S, Wakabayashi G, Ohkohchi N. Impact of three‐dimensional analysis of multidetector row computed tomography cholangioportography in operative planning for hilar cholangiocarcinoma. Am J Surg. 2011;202:441–448.
Endo I, Shimada H, Sugita M, Fujii Y, Morioka D, Takeda K, et al. Role of three‐dimensional imaging in operative planning for hilar cholangiocarcinoma. Surgery. 2007;142:666–675.
Okuda Y, Taura K, Seo S, Yasuchika K, Nitta T, Ogawa K, et al. Usefulness of operative planning based on 3‐dimensional CT cholangiography for biliary malignancies. Surgery. 2015;158:1261–1271.
Andert A, Bruners P, Heidenhain C, Ulmer F, Klink CD, Alizai PH, et al. Impact of preoperative three‐dimensional computed tomography cholangiography on postoperative resection margin status in patients operated due to hilar cholangiocarcinoma. Gastroenterol Res Pract. 2017;2017:1947023.
Kim HJ, Kim AY, Hong SS, Kim MH, Byun JH, Won HJ, et al. Biliary ductal evaluation of hilar cholangiocarcinoma: three‐dimensional direct multi–detector row CT cholangiographic findings versus surgical and pathologic results—feasibility study. Radiology. 2006;238:300–308.
Ajiki T, Fukumoto T, Ueno K, Okazaki T, Matsumoto I, Ku Y. Three‐dimensional computed tomographic cholangiography as a novel diagnostic tool for evaluation of bile duct invasion of perihilar cholangiocarcinoma. Hepato‐Gastroenterology. 2013;60:1833–1838.
Kamiya J, Yuji Nimura Y, Hayakawa N, Kondo S, Nagino M, Kanai M. Preoperative cholangiograph of the caudate lobe:surgical anatomy and staging for biliary tract carcinoma. J Hepato‐Biliary‐Pancreat Surg. 1994;1:385–389.
Jiang N, Wang SY, Xiang CH, Yu SQ, Xiao Y, Zhou CY, et al. Patterns of caudate lobe invasion of hilar cholangiocarcinoma: a panoramic histologic study of liver. Ann Surg Oncol. 2022;29:6804–6812.
Gilbert RWD, Lenet T, Cleary SP, Smoot R, Tzeng CW, Rocha FG, et al. Does caudate resection improve outcomes of patients undergoing curative resection for perihilar cholangiocarcinoma? A systematic review and meta‐analysis. Ann Surg Oncol. 2022;29:6759–6771.
Miura F, Asano T, Okazumi S, Takayama W, Shinohara Y, Makino H, et al. Rotational cine cholangiography: evaluation for use in diagnosing bile duct carcinoma. AJR Am J Roentgenol. 1999;173:1043–1048.
Furukawa H, Sano K, Kosuge T, Shimada K, Yamamoto J, Iwata R, et al. Hilar cholangiocarcinoma evaluated by three‐dimensional CT cholangiography and rotating cine cholangiography. Hepato‐Gastroenterology. 2000;47:615–620.
Chaudhary RJ, Higuchi R, Nagino M, Unno M, Ohtsuka M, Endo I, et al. Survey of preoperative management protocol for perihilar cholangiocarcinoma at 10 Japanese high‐volume centers with a combined experience of 2,778 cases. J Hepatobiliary Pancreat Sci. 2019;26:490–502.