Abstracts
1999 Digestive Disease Week

# 2076 INTRAHEPATIC EXTENSION OF HEPATOHILAR CHOLANGIOCARCINOMA VISUALIZATION BY 3-D BILIARY TRACT MAPPING
Masanori Suzuki, Tohru Takahashi, Kenji Hukuhara, Michiaki Unno, Kojin Endoh, Heigo Takeuchi, Seiki Matsuno, Tohoku Univ Sch of Medicine, Sendai Japan

Background. The spreading pattern of hepatohilar cholangiocarcinoma is difficult to study because of the three dimensional morphological features of the biliary tree branches. Purpose. In order to analyze in detail the cancerous and precancerous lesions of hilar cholangiocarcinoma, we have developed a precise technique using CG treatment. Materials and Methods. In the period between 1985 and August of 1995, we examined 26 cases of hilar cholangiocarcinoma. They consisted in: 14 cases of left hepatic lobectomy, 8 cases of right hepatic lobectomy and 4 cases of dead patients during biliary decompression The resected livers embedded with 20% gelatin blocks were serially sliced into 100-250 pieces with the thickness of 1 mm using an electrical ham slicer. The microscopic sections were prepared from each slice and the structures to be reconstructed were identified by microscope. Graphic reconstruction was performed using a computer system (PAS-310). Results. The average distance between bilateral hepatic duct confluence and cancerous advanced part was 44.5mm. As concerns the cancerous multicentricity, 13 cases (50%) were found to be monocentric and the others multicentric. There were two types of formation for multicentricity: a dysplastic epithelia intervening type (7 cases - 54%) and a type without dysplastic epithelia, with the existence of complete normal epithelium between overt carcinomatous lesions (6 cases - 46%). The former was related to de novo carcinoma. Conclusion. In order to deal with the multicentricity of carcinoma, aggressive extended radical resection should be performed.

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