Differentiation of malignant and benign proximal bile duct strictures: The diagnostic dilemma

Table 3 Results of imaging studies and intra-operative findings in patients resected for presumed HCCA

	Malignant (n = 58)	Benign (n = 10)	P
Findings on preoperative imaging
Presence of mass	56 (97%)	8 (80%)	0.10
Mean size (range, cm)	2.5 (0.7-7.0)	2.6 (1.0-3.7)	0.62
Bismuth classification
Type I, II	14	3	0.70
Type IIIa/b, IV	39	6
Intrahepatic	5	1
Vascular involvement1	21 (36%)	0 (0%)	0.03
Portal vein	19	0
Hepatic artery	6	0
Lobar atrophy	10 (17%)	1 (10%)	1.00
Lymph nodes (> 1 cm)	12 (21%)	1 (10%)	0.67
Intra-operative findings
FS performed2	57/58 (99%)	10/10 (100%)
FS positive for malignancy	20/57 (35%)	0/10 (0%)	0.03
Suspicious3-Not suspicious	51-7	5-5
Type of resection
Local bile duct resection	17 (29%)	3 (30%)
Concomitant partial hepatectomy	41 (71%)	7 (70%)

FS: Frozen section.

¹Non cumulative, patients with simultaneously portal v. and hepatic a. involvement;

²FS from suspicious lesions, lymph nodes and/or resection margins;

³A positive FS and/or palpable mass.