Outcome of surgical resection in Klatskin tumors

Serrablo, Alejandro; Tejedor, Luis

doi:10.4251/wjgo.v5.i7.147

Cited by 23 publications

(25 citation statements)

References 95 publications

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“…When these additional procedures are taken into account, the overall mortality rate of 6.8% and mortality rate in elderly of 10.7% seem reasonable and are comparable with other studies evaluating outcome after extensive liver resection (5.4-25.0%) [5,6,7,8]. Also the high complication rate of 74.6% in the present study is in line with other studies looking into large and complex liver resection that showed morbidity rates of up to 76% [26]. …”

Section: Discussionsupporting

confidence: 81%

Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Lodewick

Alizai

Dam³

et al. 2017

Dig Surg

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Background: Postresectional liver failure is the most frequent cause of fatal outcome following liver surgery. Diminished preoperative liver function in the elderly might contribute to this. Therefore, the aim of the present study was to evaluate preoperative liver function in patients <60 or >70 years of age scheduled for liver resection. Methods: All consecutive patients aged <60 or >70 years who are about to undergo elective liver surgery between 2011 and 2013 and underwent the methacetin breath liver function test (LiMAx) preoperatively were included. Histologic assessment of the resected liver gave insight into background liver disease. Correlation between age and liver function was calculated with Pearson's test. Results: Fifty-nine patients were included, 31 were aged <60 and 28 were aged >70 years. General patient characteristics and liver function LiMAx values (340 (137-594) vs. 349 (191-530) μg/kg/h, p = 0.699) were not significantly different between patients aged <60 and >70 years. Moreover, no correlation between age and preoperative liver function LiMAx values was found (R = 0.04, p = 0.810). Conclusion: Liver function did not seem to differ between younger and older patients.

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Section: Discussionsupporting

confidence: 81%

Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Lodewick

Alizai

Dam³

et al. 2017

Dig Surg

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“…Upon the completion of the tumor resection, the biliary tract reconstruction was reestablished by Roux-en-Y bilioenteric anastomosis. Vascular resection and reconstruction was carried out only when vessels adhered to and could not be freed from tumor entity during skeletonization of the hepatoduodenal ligament, regardless of whether the macrovascular invasion was detected preoperatively by MDCT [14]. Meanwhile, the end-to-end anastomosis model or vascular prothesis was employed to reestablish vascular continuity.…”

Section: Surgical Proceduresmentioning

confidence: 99%

Surgical Resection and Prognostic Analysis of 142 Cases of Hilar Cholangiocarcinoma

Zhu

Jiang

et al. 2017

Indian J Surg

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Surgical resection for hilar cholangiocarcinoma is the only curative option, but low resectability rate and poor survival outcomes remain a challenge. This study was to assess the surgical resection for hilar cholangiocarcinoma and analyze the prognostic factors influencing postoperative survival. One hundred forty-two patients with hilar cholangiocarcinoma who underwent surgical resection between January 2006 and December 2014 were analyzed retrospectively based on clinicopathological and demographic data. Univariate and multivariate analysis against outcome were employed to identify potential factors affecting prognosis. Ninety-five patients were performed with R0 resection with median survival time of 22 months; whereas, 47 patients underwent non-R0 resection (R1 = 20, R2 = 27) with that of 10 months. Of these 95 patients, 19 underwent concomitant with vascular resection and reconstruction and 2 patients underwent pancreaticoduodenectomy. 64.8% patients (n = 92) underwent combined with hepatectomy. The oneyear, three-year, and five-year survival rates after R0 resection were 76.3, 27.8, 11.3%, respectively, which was significantly better than that after non-curative resection (P = 0.000). Multivariate analysis revealed that non-curative resection (RR: 2.414, 95% CI 1.586-3.676, P = 0.000), pathological differentiation (P = 0.015) and preoperative serum total bilirubin above 10 mg/dL (RR: 1.844, 95% CI 1.235-2.752, P = 0.003) were independent prognostic factors. Aggressive curative resection remains to be the optimal option for hilar cholangiocarcinoma. Non-curative resection, pathological differentiation, and preoperative serum total bilirubin above 10 mg/ dL were associated with dismal prognosis.

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“…Serrablo et al [9] have resumed surgical outcomes in HC: All these technical improvements have been achieved without significantly increasing morbidity and mortality [1][2][3] ; mortality in HC surgery currently ranges between 0% and 11.9% [3,5] . Prof. Castellano-Megías et al [10] have reviewed the importance of an adequate and minucius pathologic study of surgical specimens in HC.…”

Section: Editorialmentioning

confidence: 99%

Hilar Cholangiocarcinoma

Miyazaki

Itoh²,

Kimura³

et al. 2016

Principles of Hepatic Surgery

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EDITORIALHilar cholangiocarcinoma (HC) is a rare tumor (0.74-1.05 ×100000 inhabitants), representing 3% of gastrointestinal cancers [1,2] . It accounts for 2/3 of the tumors of the biliary tract [1] . Although HC is frequently discussed at surgical scientific meetings and arouses great interest, it has far fewer citations than other HPB cancers and several questions regarding the condition remain unanswered in the medical literature.Untreated, the prognosis of HC is very poor. Surgery is the only therapy that offers the possibility of cure but is technically very complex [1,3] . A few years ago, the number of patients operated and resected was very low, and 5-year survival was mediocre. With recent improvements in the therapeutic strategies applied by multidisciplinary teams comprising radiologists, gastroenterologists, surgeons and oncologists, survival rates in the different series currently range from 25% to 45% [3,4] . A group of experts devoted to HC (pathologists, gastroenterologists, radiologists, surgeons and oncologists) have reviewed and updated every open question in HC in this special issue focusing in the following areas of the management and treatment of patients with HC:Prof. Valls et al [5] has updated diagnostic methods in HC: Imaging methods have improved diagnostic sensitivity and specificity, especially for determining biliary and vascular involvement. These methods include multidetector computed tomography, Cholangio-magnetic resonance, percutaneous transhepatic cholangioscopy, positron emission tomography computed tomography and staging by laparoscopy reviewed by Prof. Rotellar et al [6] . Prof. Suarez-Munoz et al [7] have updated the classification/staging systems in HC: There have been several pro- AbstractHilar cholangiocarcinoma (HC) is a rare tumor. It accounts for 2/3 of the tumors of the biliary tract. Untreated, prognosis is very poor. Surgery is the only therapy that offers the possibility of cure but is technically very complex. With recent improvements in the therapeutic strategies applied by multidisciplinary teams, survival rates in the different series currently range from 25% to 45%. A group of experts devoted to HC (pathologists, gastroenterologists, radiologists, surgeons and oncologists) have reviewed and updated every open question in HC in a special issue. Key words: Cholangiocarcinoma; Hilar; Perihilar; Klatskin; Surgery; Cancer; Review Core tip: Most remarked avances are: imaging methods have improved diagnostic sensitivity and specificity, especially for determining biliary and vascular involvement; there have been several proposals to improve the classic Bismuth-Corlette classification; preand post-operative care; technical aspects trying to obtain a R0 resection: widespread use of liver resection, resection of segment I and venous and arterial resection, refinement of post-operative histology and adjuvant therapies.

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Outcome of surgical resection in Klatskin tumors

Cited by 23 publications

References 95 publications

Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Effect of Age on Liver Function in Patients Undergoing Partial Hepatectomy

Surgical Resection and Prognostic Analysis of 142 Cases of Hilar Cholangiocarcinoma

Hilar Cholangiocarcinoma

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