Removal of intrahepatic bile duct stone could reduce the risk of cholangiocarcinoma: A single-center retrospective study in South Korea

Tae In Kim; Sung Yong Han; Jonghyun Lee; Dong Uk Kim

doi:10.12998/wjcc.v12.i5.913

Removal of intrahepatic bile duct stone could reduce the risk of cholangiocarcinoma: A single-center retrospective study in South Korea

World J Clin Cases. 2024 Feb 16;12(5):913-921. doi: 10.12998/wjcc.v12.i5.913.

Authors

Tae In Kim¹, Sung Yong Han^{1

2}, Jonghyun Lee¹, Dong Uk Kim^{1

3}

Affiliations

¹ Division of Gastroenterology, Biomedical Research Institute, Pusan National University Hospital, Busan 49241, South Korea.
² Department of Internal Medicine, Pusan National University, College of Medicine, Yangsan 50612, South Korea.
³ Department of Internal Medicine, Pusan National University, College of Medicine, Yangsan 50612, South Korea. amlm3@hanmail.net.

Abstract

Background: Intrahepatic duct (IHD) stones are among the most important risk factors for cholangiocarcinoma (CCC). Approximately 10% of patients with IHD stones develop CCC; however, there are limited studies regarding the effect of IHD stone removal on CCC development.

Aim: To investigate the association between IHD stone removal and CCC development.

Methods: We retrospectively analyzed 397 patients with IHD stones at a tertiary referral center between January 2011 and December 2020.

Results: CCC occurred in 36 of the 397 enrolled patients. In univariate analysis, chronic hepatitis B infection (11.1% vs 3.0%, P = 0.03), carbohydrate antigen 19-9 (CA19-9, 176.00 vs 11.96 II/mL, P = 0.010), stone located in left or both lobes (86.1% vs 70.1%, P = 0.042), focal atrophy (52.8% vs 26.9%, P = 0.001), duct stricture (47.2% vs 24.9%, P = 0.004), and removal status of IHD stone (33.3% vs 63.2%, P < 0.001) were significantly different between IHD stone patients with and without CCC. In the multivariate analysis, CA19-9 > upper normal limit, carcinoembryonic antigen > upper normal limit, stones located in the left or both lobes, focal atrophy, and complete removal of IHD stones without recurrence were independent factors influencing CCC development. However, the type of removal method was not associated with CCC risk.

Conclusion: Complete removal of IHD stones without recurrence could reduce CCC risk.

Keywords: Carbohydrate antigen 19-9; Cholangiocarcinoma; Endoscopic retrograde cholangiopancreatography; Intrahepatic bile duct stone; Percutaneous transhepatic cholangioscopy.