The management of extrahepatic bile duct carcinoma

Improved operative and survival outcomes of surgical treatment for hilar cholangiocarcinoma

“…This resulted in great reluctance among surgeons to perform major hepatic resection for cure in these patients 23,24,26 . Recent advances in perioperative and operative care of jaundiced patients have led to significant improvement in operative outcomes after major hepatic resection with or without major vascular resection and reconstruction, and pancreaticoduodenectomy 4,10,27 .…”

“…Instead of endoscopic stenting, routine PTBD has been recommended as the standard preoperative preparation for patients with hilar cholangiocarcinoma, and this has now gained in popularity 10,21,22 . It was suggested previously that hilar cholangiocarcinoma could be adequately treated with local resection, and bile ducts could be resected up to the tertiary branches of the hepatic ducts without liver resection 23,24 . Considering that hilar cholangiocarcinoma has a strong propensity to spread along the biliary tree and invade the surrounding tissues and vascular structures, limited resection of the bile duct alone cannot be accepted as a curative operation.…”

Role of Caudate Lobectomy in Type IIIA and IIIB Hilar Cholangiocarcinoma: A 15‐year Experience in a Tertiary Institution

“…The idea that local resection can adequately treat hilar cholangiocarcinoma is not sustainable in the current state of evidence. Previously, some authors suggested that bile ducts could be resected up to the tertiary branches of the hepatic ducts without liver resection [17, 18]. This coincided with the era when major liver resection was associated with prohibitive risk of morbidity and mortality.…”

Cost-Effectiveness Decision Analyses Comparing Covered to Uncovered Self-Expandable Metal Stents to Elective or on Demand Polyethylene Stent Changes in Patients with Distal Malignant Biliary Obstruction

“…Historically, surgical procedures were first used in the palliation of obstructive jaundice untilless invasive techniques became available [74]. Except for underdeveloped countries where endoscopic and radiological expertise is not readily available, as well as for patients with concomitant gastric outlet obstruction, surgical palliative techniques have been much less used in the management of obstructive jaundice; they have been replaced by percutaneous and endoscopic insertion of stents [75,76].…”