Resection of Hilar Cholangiocarcinoma

Ito, Fumito; Agni, Rashmi; Rettammel, Robert J.; Been, Mark J.; Cho, Clifford S.; Mahvi, David M.; Rikkers, Layton F.; Weber, Sharon M.

doi:10.1097/sla.0b013e31817f2bfd

Cited by 158 publications

(65 citation statements)

References 28 publications

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“…32 Bile duct resection combined with major hepatectomy is increasingly recognized as the standard treatment for HC, improving the obtainment of R0 resections and long-term survival. 3,4,12 In our study, the rate of R0 resections was higher with associated liver resection than with biliary confluence resection alone (79.2% vs 65.6%; P=.01). Of course, this type of resection is challenged by the close relationship between tumor and vascular structures at the hepatic hilum.…”

Section: Commentmentioning

confidence: 49%

Improvement in Perioperative and Long-term Outcome After Surgical Treatment of Hilar Cholangiocarcinoma

Nuzzo¹

2012

Arch Surg

249

203

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Section: Commentmentioning

confidence: 49%

Improvement in Perioperative and Long-term Outcome After Surgical Treatment of Hilar Cholangiocarcinoma

Nuzzo¹

2012

Arch Surg

249

203

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“…However, controversy still surrounds the choice of the procedure for patients with Bismuth type I and II cholangiocarcinomas. Reports of right hepatectomy for patients with these lesions show higher frequencies of tumor-free margins and longer survival time [16,17,18], but at the cost of increased morbidity and mortality [6,7]. Chen et al [19] conducted a retrospective review of 138 cases of cholangiocarcinoma resection and concluded that minor liver resection of Bismuth type I and II cholangiocarcinoma, selected by predetermined criteria, achieved good results.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic Resection of Bismuth Type I and II Hilar Cholangiocarcinoma: An Audit of 14 Cases from Two Institutions

De-xing³

et al. 2011

Dig Surg

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Objective: To evaluate the feasibility and safety of laparoscopic resection of Bismuth type I and II hilar cholangiocarcinoma. Background: Laparoscopic resection of hilar cholangiocarcinoma is uncommon. Method: Fourteen cases of Bismuth type I and II hilar cholangiocarcinoma were selected for laparoscopic resection. Eight cases involved local resection and 6 cases included partial hepatectomy. Results: The mean operating time and blood loss were 305 min and 386 ml, respectively. The R0 resection rate was 100 and 60% in patients with type I and II lesions, respectively. The mean postoperative hospital stay was 9 days and 19 days in patients with type I and II tumor, respectively. In-hospital mortality and morbidity were 0 and 35.7% (5 of 14 patients), respectively. Bile leakage occurred in 1 of 7 (14.3%) and 3 of 5 (60%) patients with type I and II tumors, respectively. Port-site metastases were found in 2 cases of type II tumor. The survival rate during a 20-month follow-up period was 85.7% (12 of 14 patients). Conclusion: Laparoscopic resection is a potential alternative to open surgery for appropriately selected patients with Bismuth type I hilar cholangiocarcinoma. Due to the lower R0 resection and more complications, the value of laparoscopic resection for patients with type II tumors needs further evaluation.

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“…In general, the standard therapy for HC is major hepatectomy combined with extrahepatic biliary tree resection and lymphadenectomy. 9,90–92 Left hepatectomy is required for Bismuth-Corlette IIIb lesions, while Bismuth-Corlette I, II, and IIIa lesions will usually require an extended right hepatectomy. In addition, simultaneous caudate lobe resection is highly recommended given its association with improved long-term survival and decreased local recurrence rates.…”

Section: Surgical Managementmentioning

confidence: 99%

Perioperative Management of Hilar Cholangiocarcinoma

Poruk

Pawlik

Weiss

2015

Journal of Gastrointestinal Surgery

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Background Cholangiocarcinoma is the most common primary tumor of the biliary tract although it accounts for only 2 % of all human malignancies. We herein review hilar cholangiocarcinoma including its risk factors, the main classification systems for tumors, current surgical management of the disease, and the role chemotherapy and liver transplantation may play in selected patients. Methods We performed a comprehensive literature search using PubMed, Medline, and the Cochrane library for the period 1980–2015 using the following MeSH terms: “hilar cholangiocarcinoma”, “biliary cancer”, and “cholangiocarcinoma”. Only recent studies that were published in English and in peer reviewed journals were included. Findings Hilar cholangiocarcinoma is a disease of advanced age with an unclear etiology, most frequently found in Southeast Asia and relatively rare in Western countries. The best chance of long-term survival and potential cure is surgical resection with negative surgical margins, but many patients are unresectable due to locally advanced or metastatic disease at diagnosis. As a result of recent efforts, new methods of management have been identified for these patients, including preoperative portal vein embolism and biliary drainage, neoadjuvant chemotherapy with subsequent transplantation, and chemoradiation therapy. Conclusion Current management of hilar cholangiocarcinoma depends on extent of the tumor at presentation and includes surgical resection, liver transplantation, portal vein embolization, and chemoradiation therapy. Our understanding of hilar cholangiocarcinoma has improved in recent years and further research offers hope to improve the outcome in patients with these rare tumors.

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Resection of Hilar Cholangiocarcinoma

Abstract: In patients with hilar cholangiocarcinoma, concomitant hepatic resection is associated with improved DFS, DSS, and decreased hepatic recurrence. Therefore, hepatectomy combined with bile duct resection should be considered standard treatment.

Cited by 158 publications

References 28 publications

Improvement in Perioperative and Long-term Outcome After Surgical Treatment of Hilar Cholangiocarcinoma

Improvement in Perioperative and Long-term Outcome After Surgical Treatment of Hilar Cholangiocarcinoma

Laparoscopic Resection of Bismuth Type I and II Hilar Cholangiocarcinoma: An Audit of 14 Cases from Two Institutions

Perioperative Management of Hilar Cholangiocarcinoma

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