2013
DOI: 10.1097/sla.0b013e3182708b57
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Evolution of Surgical Treatment for Perihilar Cholangiocarcinoma

Abstract: Surgical treatment of perihilar cholangiocarcinoma has been evolving steadily, with expanded surgical indication, decreased mortality, and increased survival. Survival for R0 and pN0 patients was satisfactory, whereas survival for pN1 patients was still poor, suggesting that establishment of effective adjuvant chemotherapy is needed.

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Cited by 521 publications
(271 citation statements)
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“…A recent study on CH for HCC by Jeng et al [40] reported that even with narrow margins (< 5 mm) after CH, there was no negative impact on recurrence and overall survival. Conversely, Nagino et al [64] recently commented in a review of over three decades of their experience in the evolution of surgical treatment for perihilar CCA; they reported that limited resections such a CH for perihilar CCA decreased significantly from almost 30% to less than 3% over almost 4 decades with a corresponding improved survival due to more R0 resections from extended resections. The role of CH for central HCC and perihilar CCA remains to be defined.…”
Section: Discussionmentioning
confidence: 99%
“…A recent study on CH for HCC by Jeng et al [40] reported that even with narrow margins (< 5 mm) after CH, there was no negative impact on recurrence and overall survival. Conversely, Nagino et al [64] recently commented in a review of over three decades of their experience in the evolution of surgical treatment for perihilar CCA; they reported that limited resections such a CH for perihilar CCA decreased significantly from almost 30% to less than 3% over almost 4 decades with a corresponding improved survival due to more R0 resections from extended resections. The role of CH for central HCC and perihilar CCA remains to be defined.…”
Section: Discussionmentioning
confidence: 99%
“…Surgical resection with curative intent provides the best chance of cure and long‐term survival in patients with resectable extrahepatic cholangiocarcinoma 1, 2, 3, 4, 5, 6, 7, 8, 9, 10. Recent advances in dimensional imaging, perioperative management, including biliary drainage and percutaneous transhepatic portal vein embolization, and surgical technique have resulted in increased rates of complete resection with histopathologically negative margins and improved patient survival in patients with extrahepatic cholangiocarcinoma 3, 4, 5, 6.…”
Section: Introductionmentioning
confidence: 99%
“…Recent advances in dimensional imaging, perioperative management, including biliary drainage and percutaneous transhepatic portal vein embolization, and surgical technique have resulted in increased rates of complete resection with histopathologically negative margins and improved patient survival in patients with extrahepatic cholangiocarcinoma 3, 4, 5, 6. However, cancer‐free resection margins at the bile duct stump are difficult to achieve because of longitudinal extension, which is one of the prominent characteristics of extrahepatic cholangiocarcinoma 11, 12.…”
Section: Introductionmentioning
confidence: 99%
“…In a single‐center, 34‐year review of 574 consecutive patients, Nagino et al 45. published the results of what is the world's largest cohort of patients who have undergone surgical treatment for perihilar cholangiocarcinoma.…”
Section: Biliary Surgerymentioning
confidence: 99%