Incidence of Cholangiocarcinoma with or without Previous Resection of Liver for Hepatolithiasis.

BACKGROUND/AIMS: To investigate the incidence of cholangiocarcinoma in patients with hepatolithiasis with or without previous resection of liver. METHODS: From 2002 to 2009, we retrospectively reviewed 117 patients who were diagnosed and treated for hepatolithiasis in Korea University Guro Hospital. Among the 117 patients, 55 patients who were lost during follow-up were excluded, and 62 patients were eligible for analysis. The hepatic resection group (n=25) included patients who underwent left hemihepatectomy (n=2); left lateral segmentectomy (n=10); left lobectomy (n=9); right lobectomy (n=3); or wedge resection (n=1). The nonhepatic resection group (n=37) included transhepatic cholangiographic lithotomy and endoscopic retrograde cholangiopancreatography-treated patients. The mean follow-up period was 47 months. RESULTS: The incidence of cholangiocarcinoma while patients were followed for hepatolithiasis was 12.9% (8/62) (hepatic resection group, three cases [12%] vs nonhepatic resection group, five cases [13.5%]; p=1.000). The mean follow-up period was 53 months (47±11 months) until the diagnosis of cholangiocarcinoma. CONCLUSIONS: There was no difference in the incidence of cholangiocarcinoma according to previous liver resections. Patients with hepatolithiasis should be carefully followed up for detection of cholangiocarcinoma even after a previous liver resection.

A novel technique for retrieval of a drug-eluting stent after catheter break and stent loss.

Break of a stent delivery catheter and subsequent stent loss (SL) has been a rare event in the drug-eluting stent (DES) era. We here report a case of successful retrieval of a stent after a break if the delivery catheter and SL from a balloon catheter at a culprit lesion. We finally resolved this situation using a simple balloon technique for both the broken stent catheter inside of the guide catheter and the unexpanded stent in the culprit lesion. Thus balloons are an important weapon in our armamentarium in the cardiac catheterization laboratory for urgent retrieval of a lost stent. Their apt use definitely allowed our patient to avoid undergoing emergency cardiovascular thoracic surgery.

Unusual dominant course of left circumflex coronary artery to right coronary artery territory with absent right coronary artery.

A single coronary artery (SCA) is a rare congenital anomaly of the coronary circulation, which is often associated with other congenital anomalies. The reported incidence of a SCA ranges from 0.6 to 1.3% of the population undergoing coronary angiography. The absence of the right coronary artery (RCA) with the origin of the RCA arising from the distal circumflex artery is an extremely rare variant of the SCA. The incidence of the anomaly is uncertain, with few cases reported. We report the case of a 68-year-old female, in whom the RCA arises as an extension of the distal left circumflex coronary artery.