Extended Resections for Hilar Cholangiocarcinoma
Open Access
- 1 December 1999
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in Annals of Surgery
- Vol. 230 (6), 808
- https://doi.org/10.1097/00000658-199912000-00010
Abstract
To evaluate different strategies for extended resections of hilar cholangiocarcinomas on radicality and survival. Surgical resection of hilar cholangiocarcinoma is the only potentially curative treatment. Resection of central bile duct carcinomas, however, cannot always comply with the general principles of surgical oncology to achieve wide tumor-free margins with no-touch techniques. From 1988 to 1998, 95 patients underwent resection of hilar cholangiocarcinoma. Eighty patients had hilar and hepatic resections and 15 had liver transplantation and partial pancreatoduodenectomy (LTPP;i.e., eradication of the entire biliary tract using a no-touch technique). The 60-day death rate was 8%. The overall 1- and 5-year survival rates were 67% and 22%, respectively. Five-year survival rates after R0, R1, and R2 resections were 37%, 9%, and 0%. In a multivariate analysis, surgical radicality was the strongest determinant of survival (p versus Extended resections, especially right trisegmentectomies and LTPP, resulted in the highest rate of R0 resection. Right trisegmentectomy together with portal vein resection best represents the principles of surgical oncology and may be regarded as the surgical procedure of choice. Immunosuppression limits the applicability of LTPP.Keywords
This publication has 31 references indexed in Scilit:
- Factors Influencing Postoperative Morbidity, Mortality, and Survival After Resection for Hilar CholangiocarcinomaAnnals of Surgery, 1996
- Conversion to tacrolimus after liver transplantationTransplant International, 1996
- Conversion to tacrolimus after liver transplantationTransplant International, 1996
- Biliary Tumors of the LiverSeminars in Liver Disease, 1995
- Management Strategies in Resection for Hilar CholangiocarcinomaAnnals of Surgery, 1992
- Clinical Significance of Implantation Metastases After Surgical Treatment of CholangiocarcinomaSeminars in Liver Disease, 1990
- Abdominal Organ Cluster Transplantation for the Treatment of Upper Abdominal MalignanciesAnnals of Surgery, 1989
- Clinicopathological Aspects of High Bile Duct CancerAnnals of Surgery, 1984
- Pathological aspects of cholangiocarcinomaThe Journal of Pathology, 1983
- PREOPERATIVE EXTERNAL BILIARY DRAINAGE IN OBSTRUCTIVE JAUNDICEThe Lancet, 1982