Hepatopancreatoduodenectomy with simultaneous resection of the portal vein and hepatic artery: Ultimate superextended surgery for advanced perihilar cholangiocarcinoma

Nagino, Masato

doi:10.1002/jhbp.1102

Cited by 2 publications

(1 citation statement)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Although it could be argued that the more liberal use of a frozen section would have aided the intra-operative recognition of an involved margin, the liver transection was undertaken as far away from the confluence as feasible, and thus, it is unlikely that a more extensive hepatectomy could have been undertaken. Hepatopancreatoduodenectomy was not utilised in this series [ 24 ]. Liver transplantation is also an option in this setting and renders R1 resection margins immaterial [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

Work-Up and Outcome of Hepatic Resection for Peri-Hilar Cholangiocarcinoma (PH-CCA) without Staging Laparoscopy

Jegatheeswaran

Stathakis

Spiers

et al. 2022

Cancers

View full text Add to dashboard Cite

Background: This study reports the outcome of a work-up programme for resection of peri-hilar cholangiocarcinoma (PH-CCA) without the use of staging laparoscopy. Methods: This is a clinical case cohort series of patients undergoing surgical resection of PH-CCA without the use of staging laparoscopy in the work-up algorithm. During the 13 years from 1 January 2009 to 1 January 2022, 32 patients underwent laparotomy for planned surgical resection of PH-CCA. Data were collected on demographic profile, admission biochemistry, radiology, pre-operative intervention, operation and outcome, together with post-operative complications and disease-free and overall survival. Results: All patients underwent pre-operative contrast-enhanced CT. Twenty-four (75%) underwent pre-operative MR. Twenty-three (72%) underwent pre-operative biliary drainage. Twenty-nine patients (91%) had either type III or IV peri-hilar cholangiocarcinoma. One patient (3%) in this series underwent a non-resectional laparotomy. Twenty-nine (91%) had a final histopathological diagnosis of PH-CCA. One further patient had a final diagnosis of an intraductal papillary neoplasm of the biliary tree (IPNB) with high-grade dysplasia but no invasive cancer. Eleven patients (36%) received chemotherapy after surgery. The median (95% CI) time to recurrence was 14 (7–31) months. The median survival was 25 (18-upper limit not reached) months. Conclusion: This cohort of 32 patients undergoing attempted resection for PH-CCA without the use of staging laparoscopy in the work-up algorithm indicates that with careful attention to patient fitness and cross-sectional and interventional radiologic/endoscopic imaging, a very low non-therapeutic laparotomy rate of 3% can be achieved and sustained.

show abstract

Section: Discussionmentioning

confidence: 99%