Featured Research

from universities, journals, and other organizations

How To Differentiate Benign From Malignant Bile Duct Strictures?

Date:
September 12, 2008
Source:
World Journal of Gastroenterology
Summary:
The differentiation of benign and malignant strictures is difficult. Recently, a group of clinical specialists in Netherlands attempted to find possible criteria for differentiation of malignant from benign bile duct strictures. They found that except for vascular involvement which was associated significantly with malignancy, there were no conclusive features of malignancy on regular imaging modalities.

The main etiology of bile duct strictures closely related to the liver is a malignancy (cancer). However, the differentiation of benign and malignant strictures is notoriously difficult.

The consequences for the patient are considerable because cancer in this anatomical location requires extensive surgery with removal of a large part of the liver. Extensive work-up including multi-slice computed tomography (CT), colour Doppler ultrasonography and magnetic resonance imaging (MRI) may improve the diagnostic dilemma. However, up to date, no single investigation reliably differentiates malignant from benign bile duct strictures.

A research article to be published on August 28, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. van Gulik from the Surgical Department, analyzed a patient cohort that underwent resection for presumed malignancy of the bile duct, during the period 1998 to 2006. The final histologic diagnosis of 68 patients was correlated with the preoperative clinical, laboratory and radiological findings. Fifteen percent patients were found to have a benign lesion.

The findings of the different imaging studies revealed that only one feature, i.e. involvement of the blood vessels, showed a significant association with malignany. All other features including clinical presentation, laboratory tests, brush cytology, and other imaging studies were unable to differentiate malignant and benign strictures.

Invasion of the blood vessels was based on the findings of colour Doppler ultrasonography defined as an increase of flow compatible with stenosis, or absence of flow compatible with occlusion. Furthermore, vascular involvement was identified on contrast enhanced CT as vascular stenosis or occlusion of the portal vein and/or the hepatic artery. In 21 patients, the portal vein and/or branches of the hepatic artery were involved in the tumor process, and all these patients were finally diagnosed to have a malignant lesion.

Despite using recent, state-of-the-art imaging modalities, 15% patients with presumed malignancy underwent an extensive operation but were ultimately diagnosed to have benign strictures. Due to the relatively low incidence of vascular involvement (31% in this series), the absence of this finding is not conclusive. The article demonstrates that the differentiation of bile duct strictures remains difficult and that more research is needed to solve this diagnostic problem.


Story Source:

The above story is based on materials provided by World Journal of Gastroenterology. Note: Materials may be edited for content and length.


Journal Reference:

  1. Kloek JJ, van Delden OM, Erdogan D, ten Kate FJ, Rauws EA, Busch OR, Gouma DJ, van Gulik TM. Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma. World J Gastroenterol, 2008; 14(32): 5032-5038 [link]

Cite This Page:

World Journal of Gastroenterology. "How To Differentiate Benign From Malignant Bile Duct Strictures?." ScienceDaily. ScienceDaily, 12 September 2008. <www.sciencedaily.com/releases/2008/09/080909094740.htm>.
World Journal of Gastroenterology. (2008, September 12). How To Differentiate Benign From Malignant Bile Duct Strictures?. ScienceDaily. Retrieved August 23, 2014 from www.sciencedaily.com/releases/2008/09/080909094740.htm
World Journal of Gastroenterology. "How To Differentiate Benign From Malignant Bile Duct Strictures?." ScienceDaily. www.sciencedaily.com/releases/2008/09/080909094740.htm (accessed August 23, 2014).

Share This




More Health & Medicine News

Saturday, August 23, 2014

Featured Research

from universities, journals, and other organizations


Featured Videos

from AP, Reuters, AFP, and other news services

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Drug Used To Treat 'Ebola's Cousin' Shows Promise

Newsy (Aug. 21, 2014) An experimental drug used to treat Marburg virus in rhesus monkeys could give new insight into a similar treatment for Ebola. Video provided by Newsy
Powered by NewsLook.com
Two US Ebola Patients Leave Hospital Free of the Disease

Two US Ebola Patients Leave Hospital Free of the Disease

AFP (Aug. 21, 2014) Two American missionaries who were sickened with Ebola while working in Liberia and were treated with an experimental drug are doing better and have left the hospital, doctors say on August 21, 2014. Duration: 01:05 Video provided by AFP
Powered by NewsLook.com
Cadavers, a Teen, and a Medical School Dream

Cadavers, a Teen, and a Medical School Dream

AP (Aug. 21, 2014) Contains graphic content. He's only 17. But Johntrell Bowles has wanted to be a doctor from a young age, despite the odds against him. He was recently the youngest participant in a cadaver program at the Indiana University NW medical school. (Aug. 21) Video provided by AP
Powered by NewsLook.com
American Ebola Patients Released: What Cured Them?

American Ebola Patients Released: What Cured Them?

Newsy (Aug. 21, 2014) It's unclear whether the American Ebola patients' recoveries can be attributed to an experimental drug or early detection and good medical care. Video provided by Newsy
Powered by NewsLook.com

Search ScienceDaily

Number of stories in archives: 140,361

Find with keyword(s):
Enter a keyword or phrase to search ScienceDaily for related topics and research stories.

Save/Print:
Share:

Breaking News:
from the past week

In Other News

... from NewsDaily.com

Science News

Health News

Environment News

Technology News



Save/Print:
Share:

Free Subscriptions


Get the latest science news with ScienceDaily's free email newsletters, updated daily and weekly. Or view hourly updated newsfeeds in your RSS reader:

Get Social & Mobile


Keep up to date with the latest news from ScienceDaily via social networks and mobile apps:

Have Feedback?


Tell us what you think of ScienceDaily -- we welcome both positive and negative comments. Have any problems using the site? Questions?
Mobile: iPhone Android Web
Follow: Facebook Twitter Google+
Subscribe: RSS Feeds Email Newsletters
Latest Headlines Health & Medicine Mind & Brain Space & Time Matter & Energy Computers & Math Plants & Animals Earth & Climate Fossils & Ruins