De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis

Carmen Landaverde, Vivian Ng, Alisa Sato, James Tabibian, Francisco Durazo, Ronald Busuttil

Research output: Contribution to journalArticle

24 Scopus citations

Abstract

Primary sclerosing cholangitis (PSC) is a chronic, progressive, inflammatory and obstructive disease of the intra- and extra-hepatic bile ducts of unknown etiology. Currently, orthotopic liver transplantation (OLT) is the only definitive treatment for PSC-related end-stage liver disease. However, PSC has been known to recur in the grafted liver. Roux-en-Y hepaticojejunostomy is more commonly performed than choledocho-choledochostomy for PSC, although choledochocholedochostomy has been found to be safe and efficacious for PSC if the distal common bile duct is uninvolved at the time of OLT. Our case is unique in that it describes a patient who developed de-novo cholangiocarcinoma in the remnant portion of the native common bile duct six years after OLT with choledochocholedochostomy for PSC-associated end-stage liver disease without having PSC recurrence. In conclusion, our case report indicates that choledochocholedochostomy may not be desirable in PSC due to an increased risk of developing cholan-giocarcinoma in the native common bile duct. This risk exists as well with a Roux-en-Y hepaticojejunos-tomy in the remaining intra-duodenal and intra-pancreatic biliary epithelium, although in theory to a lesser extent. Therefore, the risk of developing cholangiocarcinoma in the recipient common bile duct can only be completely eliminated by performing a Whipple procedure at the time of OLT.

Original languageEnglish (US)
Pages (from-to)379-383
Number of pages5
JournalAnnals of Hepatology
Volume8
Issue number4
StatePublished - Oct 2009

Keywords

  • Primary sclerosing cholangitis. orthotopic liver transplantation. choledochocholedochostomy

ASJC Scopus subject areas

  • Hepatology
  • Medicine(all)

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    Landaverde, C., Ng, V., Sato, A., Tabibian, J., Durazo, F., & Busuttil, R. (2009). De-novo cholangiocarcinoma in native common bile duct remnant following OLT for primary sclerosing cholangitis. Annals of Hepatology, 8(4), 379-383.