XXXX of the biliary tract: treating a rare cause of bile duct obstruction.

@entity1 @entity1087 @entity5 @entity1126 @entity201 @entity6984 @entity253
@entity253 are rare with fewer than 30 cases reported in the English literature. The objective of this report is to describe an additional @entity1 found to have a @entity253 and to define the presentation, diagnosis, and management of @entity1 with this rare @entity5 . In our case the @entity1 initially presented with clinical @entity1087 and elevated transaminases. Endoscopic retrograde cholangiogram established a mass suspicious for @entity201 ( @entity6984 ). The @entity1 was initially managed with an endostent, which was later removed in favor of a percutaneous transhepatic cholangiogram tube. At the time of surgery successful removal of a firm nodular mass at the area of the ductal bifurcation was achieved and biliary continuity re-established with a Roux-en-Y hepaticojejunostomy. Pathology revealed @entity5 of the bile duct with one lymph node positive for @entity5 . The @entity1 did not receive any adjuvant radiation or chemotherapy. This case serves to highlight that extrahepatic @entity253 constitute a rare but identifiable subset of @entity1126 . Diagnostic workup should include US, CT, and cholangiography. Surgical exploration is universally indicated in physiologically fit @entity1 with operative management to include resection and re-establishment of biliary continuity. Data on adjuvant therapy remain investigational; however, available information suggests that @entity1 with @entity253 have an overall favorable prognosis after aggressive surgical management.
