Forty Consecutive Resections of Hilar Cholangiocarcinoma With No Postoperative Mortality and No Positive Ductal Margins

Abstract

No postoperative mortality and no positive ductal margins were achieved according to the above guidelines in a high-volume expert center. Long-term results, however, have not been significantly improved. A survival analysis of the patient series with homogeneous conditions derived from a short study period suggests the need for additional strategies including right hepatectomy for Bismuth type I or II tumors.

Endoscopic nasobiliary drainage is the most suitable preoperative biliary drainage method in the management of patients with hilar cholangiocarcinoma

“…[5,7,8]. Portal vein or arterial reconstruction was performed even when resectable vascular invasion (portal vein or artery) existed [7,8].…”

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

“…All patients underwent surgical treatment in accordance with the departmental guidelines, which have been reported previously 1 . Using univariate and multivariate analyses, we investigated a wide range of clinical, hematological, surgical, and pathological factors to identify independent prognostic factors that were available preoperatively.…”

“…Surgical resection is the only treatment option to cure perihilar cholangiocarcinoma [1][2][3][4][5][6][7][8][9][10][11] . However, mortality and morbidity rates after surgical resection are 0-15% and 14-66%, respectively, which are rather high compared with other cancers.…”

“…However, mortality and morbidity rates after surgical resection are 0-15% and 14-66%, respectively, which are rather high compared with other cancers. Five-year overall survival rates reported from high-volume centers ranged at 22 to 40% [1][2][3][4][5][6][7][8][9][10][11] . These findings indicate that only selected patients could achieve satisfactory beneficial effects from surgical treatment.…”

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

“…Unilobar disease is considered resectable, even with ipsilateral encasement of the hepatic artery or portal vein branch, and/or involvement of ipsilateral secondary biliary radicals with associated lobar atrophy. A concomitant partial hepatectomy is the single most important factor leading to improved outcomes after resection of extrahepatic bile duct tumors (65,66). Several strategies have been developed to improve outcomes.…”