Abstract
We report the case of metastatic tumor recurrence at the chest wall exit site of percutaneous transhepatic biliary drainage (PTBD) catheter four months after surgical resection for cholangiocarcinoma. We discuss the risks and benefits of using PTBD catheters preoperatively in patients with planned major liver resection for malignancy.
Highlights
Percutaneous transhepatic biliary drainage (PTBD) has become an established and effective method in the management of malignant obstructive jaundice, mainly in patients with unresectable disease
Metastatic tumor seeding along the transhepatic biliary catheter is a very rare complication and until now there have been very few reported cases [7]
We present a case of metastasis along PTBD catheter tract in a patient after extended right hepatectomy for cholangiocarcinoma
Summary
Percutaneous transhepatic biliary drainage (PTBD) has become an established and effective method in the management of malignant obstructive jaundice, mainly in patients with unresectable disease. We present a case of metastasis along PTBD catheter tract in a patient after extended right hepatectomy for cholangiocarcinoma. Upon further work-up, a computed tomography revealed a 4.1 x 2.5 x 1.8 cm lesion in segment V suspicious for cholangiocarcinoma, along with a distended abnormallooking gallbladder and intrahepatic biliary obstruction. The patient developed symptoms of cholangitis which required a percutaneous transhepatic biliary drainage catheter placement. Cholangiogram showed occlusion of the right biliary radicles at the level of the porta hepatis despite the presence of the stent that was placed via ERCP. The patient underwent chemotherapy and radiation with no response and died 10 months after surgery
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