Abstract
Percutaneous transhepatic cholangiodrainage (PTCD) and percutaneous transhepatic choledochoscopy (PTCS) can be employed as preoperative diagnosis of bile duct cancer, when caution should be exercised to posibble complications including intrahepatic hemangioma, choleperitonitis, peritonitis carcinomatosa, and implantation of cancer cells. This time we experienced a case of mucus producing bile duct carcinoma recurred in the PTCD fistula.
A 51-year-old woman underwent preoperative PTCD with a diagnosis of intrahepatic bile duct cancer. On the 34th day after hepatectomy or 49th day after a PTCD tube was inserted, an induration was felt in subcutaneous tissue at the fistula which was the same site as the PTCD tube was inserted. With a diagnosis of recurrence to the subcutaneous tissue at the PTCD fistula, the tumor was excised. Histopathological findings of the site was the same as those of intrahepatic bile duce carcinoma. However, on the 150th day after the PTCD tube was inserted, another induration was felt at the same site. It was diagnosed as re-recurrence, and an excision of the tumor and associated resection of the 7 and 8th libs and diaphragm were performed. In a review of the literature, recurrence of bile duct cancer to the PTCD fistula is rare, but there may arise some future problem in the management of PTCD.
