Actual Long-term Outcome of Extrahepatic Bile Duct Cancer After Surgical Resection

Surgery for extrahepatic cholangiocarcinoma: predictors of survival

“…Surprisingly, only five studies confirmed the TNM staging system as an independent prognostic factor [2,35,46Á48]. In several studies, the staging system had no predictive value for survival [3,8,21,32,33,49] and, in a few, only in univariate analysis [23,31,50].…”

Clinicopathological analysis and prognosis of extrahepatic bile duct cancer with a microscopic positive ductal margin

“…4 However, tumours are rarely confined to the short segment as bile duct cancer tends to longitudinally spread along the bile duct wall. 6,7 Recent advances in imaging modalities and surgical strategies have improved the outcome of the surgical treatment for EHBD cancer. A surgical resection for EHBD cancer is determined by the location and extent of the tumour.…”

“…A surgical resection for EHBD cancer is determined by the location and extent of the tumour. 3,[6][7][8][9][10][11][12][13] Although a pre-operative diagnosis for the extension of EHBD cancer has improved in recent years, it is difficult to decide the surgical resection margin pre-operatively. 13,14 In some patients, a margin positive resection was inevitable considering the operative risk.…”

Preoperative assessment of longitudinal extension of cholangiocarcinoma with peroral video‐cholangioscopy: A prospective study

“…1,2,5,10,11 In contrast, distal extrahepatic cholangiocarcinoma (DCCA) is usually managed by pancreatoduodenectomy. 3,4,7,12 In patients with poor general condition who are intolerant toward hepatectomy or pancreatoduodenectomy, bile duct resection alone is indicated if the CCA is a papillary-type lesion and is limited to the proximal common hepatic duct or distal extrahepatic duct, without intrapancreatic common bile duct involvement or apparent lymph node metastasis. 7,12 Hepatopancreatoduodenectomy is considered when longitudinal extension of CCA ranges from the hilar bile duct to the intrapancreatic common bile duct.…”

“…3,4,7,12 In patients with poor general condition who are intolerant toward hepatectomy or pancreatoduodenectomy, bile duct resection alone is indicated if the CCA is a papillary-type lesion and is limited to the proximal common hepatic duct or distal extrahepatic duct, without intrapancreatic common bile duct involvement or apparent lymph node metastasis. 7,12 Hepatopancreatoduodenectomy is considered when longitudinal extension of CCA ranges from the hilar bile duct to the intrapancreatic common bile duct. 7,13 Therefore, preoperative assessment of longitudinal extension of CCA is essential for deciding surgical resectability and selecting operative procedures.…”