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Copyright ©2005 Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Nov 28, 2005; 11(44): 7024-7027
Published online Nov 28, 2005. doi: 10.3748/wjg.v11.i44.7024
Catheter tract implantation metastases associated with percutaneous biliary drainage for extrahepatic cholangiocarcinoma
Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Tatsuya Nomura, Eiko Sakata, Katsuyoshi Hatakeyama
Jun Sakata, Yoshio Shirai, Toshifumi Wakai, Tatsuya Nomura, Eiko Sakata, Katsuyoshi Hatakeyama, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
Author contributions: All authors contributed equally to the work.
Correspondence to: Yoshio Shirai, MD, PhD, Division of Digestive and General Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata City 951-8510, Japan. shiray@med.niigata-u.ac.jp
Telephone: +81-25-227-2228 Fax: +81-25-227-0779
Received: April 15, 2005
Revised: July 12, 2005
Accepted: July 15, 2005
Published online: November 28, 2005
Abstract

AIM: To estimate the incidence of catheter tract implantation metastasis among patients undergoing percutaneous transhepatic biliary drainage (PTBD) for extrahepatic cholangiocarcinoma, and to provide data regarding the management of this unusual complication of PTBD by reviewing cases reported in the literature.

METHODS: A retrospective analysis of 67 consecutive patients who underwent PTBD before the resection of extrahepatic cholangiocarcinoma was conducted. The median follow-up period after PTBD was 106 mo. The English language literature (PubMed, National Library of Medicine, Bethesda, MD, USA), from January 1966 through December 2004, was reviewed.

RESULTS: Catheter tract implantation metastasis developed in three patients. The cumulative incidence of implantation metastasis reached a plateau (6%) at 20 mo after PTBD. All of the three patients with implantation metastasis died of tumor progression at 3, 9, and 20 mo after the detection of this complication. Among the 10 reported patients with catheter tract implantation metastasis from extrahepatic cholangiocarcinoma (including our three patients), two survived for more than 5 years after the excision of isolated catheter tract metastases.

CONCLUSION: Catheter tract implantation metastasis is not a rare complication following PTBD for extrahepatic cholangiocarcinoma. Although the prognosis for patients with this complication is generally poor, the excision of the catheter tract may enable survival in selected patients with isolated metastases along the catheter tract.

Keywords: Neoplasm seeding; Extrahepatic cholangiocarcinoma; Percutaneous transhepatic biliary drainage; Malignant biliary obstruction; Surgery; Prognosis