Hilar cholangiocarcinoma evaluated by three-dimensional CT cholangiographyand rotating cine cholangiography

Background/Aims: To evaluate the usefulness of three-dimensional cholangiog raphy and rotating cine cholangiography in depicting the anatomy of the hil ar bile duct and tumor extension, and in planning surgical procedures for h ilar cholangiocarcinomas. Methodology: Five patients with hilar cholangiocarcinoma and obstructive ja undice who underwent percutaneous transhepatic biliary drainage followed by resection were serially examined by cine cholangiography and three-dimensi onal cholangioraphy which were reconstructed from a helical computed tomogr aphy scan. Tumor extension to the bile ducts was prospectively diagnosed an d the resect;ion margin was planned using both cine and three-dimensional c holangiograms. The histological evaluation of the resected specimens were c ompared with preoperative findings of cholangiograms. Results: The three-dimensional cholangiograms from vertical projection demo nstrated the bile duct anatomy with excellent image quality. To assess tumo r invasion to the intrahepatic bile ducts, cine cholangiograms from lateral and oblique projections were necessary. Selection of the surgical procedur e was influenced by preoperative evaluations of the lesion on both three-di mensional and cine cholangiograms. Histologically, the resected margin was free from tumor in all cases, Conclusions: Three-dimensional and cine cholangiography allowed accurate as sessment of the biliary system in patients with hilar cholangiocarcinoma, w hich was helpful for planning the surgical procedure.