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High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy.

Publication ,  Journal Article
Bickenbach, KA; Shia, J; Klimstra, DS; DeMatteo, RP; Fong, Y; Kingham, TP; Allen, PJ; Jarnagin, WR; D'Angelica, MI
Published in: HPB (Oxford)
December 2011

BACKGROUND: A total of 750,000 cholecystectomies are performed annually in the USA. No data exist on patients with microscopic high-grade dysplasia at the cystic duct margin and the associated incidence of cholangiocarcinoma. METHODS: Pathology reports for 1992-2010 were reviewed for patients with high-grade dysplasia of the cystic duct margin in the absence of invasive gallbladder cancer. Clinical data were obtained from chart review. RESULTS: Five patients with high-grade dysplasia at the cystic duct margin without evidence of malignancy were identified. Radiologic imaging was abnormal in two patients. The cystic duct stump was abnormally dilated in both patients and one patient had an enlarged portacaval lymph node. All five patients underwent exploration and resection of either the cystic duct stump or the bile duct. Specimens in four of the patients showed no evidence of malignancy or dysplasia. One patient was found to have a node-positive adenocarcinoma of the cystic duct. CONCLUSIONS: High-grade dysplasia at the cystic duct margin without evidence of invasive gallbladder cancer is rare. Patients with this finding should undergo cross-sectional imaging and a diagnosis of an underlying cholangiocarcinoma should be considered, especially if imaging reveals any abnormalities.

Duke Scholars

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

December 2011

Volume

13

Issue

12

Start / End Page

865 / 868

Location

England

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Predictive Value of Tests
  • New York City
  • Middle Aged
  • Male
  • Humans
  • Female
  • Dilatation, Pathologic
 

Citation

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Bickenbach, K. A., Shia, J., Klimstra, D. S., DeMatteo, R. P., Fong, Y., Kingham, T. P., … D’Angelica, M. I. (2011). High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy. HPB (Oxford), 13(12), 865–868. https://doi.org/10.1111/j.1477-2574.2011.00388.x
Bickenbach, Kai A., Jinru Shia, David S. Klimstra, Ronald P. DeMatteo, Yuman Fong, T Peter Kingham, Peter J. Allen, William R. Jarnagin, and Michael I. D’Angelica. “High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy.HPB (Oxford) 13, no. 12 (December 2011): 865–68. https://doi.org/10.1111/j.1477-2574.2011.00388.x.
Bickenbach KA, Shia J, Klimstra DS, DeMatteo RP, Fong Y, Kingham TP, et al. High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy. HPB (Oxford). 2011 Dec;13(12):865–8.
Bickenbach, Kai A., et al. “High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy.HPB (Oxford), vol. 13, no. 12, Dec. 2011, pp. 865–68. Pubmed, doi:10.1111/j.1477-2574.2011.00388.x.
Bickenbach KA, Shia J, Klimstra DS, DeMatteo RP, Fong Y, Kingham TP, Allen PJ, Jarnagin WR, D’Angelica MI. High-grade dysplasia of the cystic duct margin in the absence of malignancy after cholecystectomy. HPB (Oxford). 2011 Dec;13(12):865–868.
Journal cover image

Published In

HPB (Oxford)

DOI

EISSN

1477-2574

Publication Date

December 2011

Volume

13

Issue

12

Start / End Page

865 / 868

Location

England

Related Subject Headings

  • Surgery
  • Retrospective Studies
  • Reoperation
  • Predictive Value of Tests
  • New York City
  • Middle Aged
  • Male
  • Humans
  • Female
  • Dilatation, Pathologic