Surgery for hilar cholangiocarcinoma: The Leeds experience

Hidalgo, Ernest; Asthana, Sonal; Nishio, Hisahide; Wyatt, Judy; Toogood, Giles J.; Prasad, K. Raj; Lodge, J. Peter A.

doi:10.1016/j.ejso.2007.10.005

Cited by 110 publications

(93 citation statements)

References 43 publications

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“…Surgical resection is the only treatment option to cure perihilar cholangiocarcinoma [1][2][3][4][5][6][7][8][9][10][11] . However, mortality and morbidity rates after surgical resection are 0-15% and 14-66%, respectively, which are rather high compared with other cancers.…”

Section: Introductionmentioning

confidence: 99%

“…However, mortality and morbidity rates after surgical resection are 0-15% and 14-66%, respectively, which are rather high compared with other cancers. Five-year overall survival rates reported from high-volume centers ranged at 22 to 40% [1][2][3][4][5][6][7][8][9][10][11] . These findings indicate that only selected patients could achieve satisfactory beneficial effects from surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

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A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Saito

Noji

Okamura

et al. 2016

Surgery

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Saito

Noji

Okamura

et al. 2016

Surgery

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“…1,4 The rate of resection margin involvement in our resected patients (50%) is similar to that of other published series where R0 rates of 40-60% have been reported. 1,6,15,16 conclusions Our results reveal the major difficulties in achieving effective and lasting biliary drainage either for definitive palliation or as a prelude to surgery. These difficulties are often overlooked in series describing the effect of active treatments, which are only possible after biliary drainage has been achieved.…”

Section: Discussionmentioning

confidence: 75%

“…3,4 Five-year survival rates of 20-35%, however, have been achieved in published series. 1,3,5,6 Chemotherapy used in the treatment of inoperable HC includes gemcitabine and cisplatin. A disease control rate of 81% and a median survival of 11.7 months have been reported in the largest published series to date.…”

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confidence: 99%

Low rate of active treatment of patients with hilar cholangiocarcinoma

Mishreki

Lim

Cranefield

et al. 2013

annals

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INTRODUCTIONThe results of surgical resection and palliative chemotherapy use in hilar cholangiocarcinoma (HC) have been well publicised but the proportion of patients able to undergo these treatments and the comparative outcomes in a population of patients with HC are less well known. METHODS Patients with HC were identified by review of all patients undergoing percutaneous cholangiography over a nineyear period (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010) in a tertiary facility. The treatment undertaken and outcomes were recorded. RESULTS Overall, 68 patients were identified (37 female) with a median age of 70 years. Forty-five (66%) were treated solely by insertion of a metal stent (median survival 4.73 months) and nine (13%) also received palliative chemotherapy (median survival 13.7 months). Persisting jaundice after stent insertion was noted in 18 of 35 patients (51%) tested within one month of death. Fourteen patients (21%) underwent surgical resection (median survival 20.2 months). CONCLUSIONS Patients undergoing surgical resection had significantly longer survival than those receiving only a palliative stent but not compared with those also receiving palliative chemotherapy, with short-term follow-up. Only a third of patients, however, receive active treatment (surgery or chemotherapy) and improvements in long-term biliary palliation are needed.

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“…Mortality and morbidity after major hepatectomy in patients with perihilar cholangiocarcinoma (PHCC) have been reported to be higher than those in patients with other liver tumours [1-3]. A recent report from a Western high-volume centre revealed that postoperative mortality after major hepatectomy for PHCC was >10% and that the morbidity rate was similar to several other high-volume centres [4].…”

Section: Introductionmentioning

confidence: 99%

Postoperative Liver Failure Criteria for Predicting Mortality after Major Hepatectomy with Extrahepatic Bile Duct Resection

et al. 2018

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Background: Post-hepatectomy liver failure (PHLF) is a serious complication after major hepatectomy with extrahepatic bile duct resection (Hx with EBDR) that may cause severe morbidity and even death. The purpose of this study was to compare several criteria systems as predictors of PHLF-related mortality following Hx with EBDR for perihilar cholangiocarcinoma (PHCC). Methods: The study cohort consisted of 222 patients who underwent Hx with EBDR for PHCC. We compared several criteria systems, including previously established criteria (the International Study Group of Liver Surgery (ISGLS) criterion; and the “50-50” criterion), and our institution’s novel systems “Max T-Bili” defined as total bilirubin (T-Bili) >7.3 mg/dL during post-operative days (POD) 1–7, and the “3-4-50” criterion, defined as total bilirubin >4 mg/dL and prothrombin time <50% on POD #3. Results: Thirteen patients (5.8%) died from PHLF-related causes. The 3-4-50 criterion showed high positive predictive values (39.1%), the 3-4-50, Max T-Bili, and 50-50 criterion showed high accuracies (91.7, 86.9, and 90.5%, respectively) and varying sensitivities (69.2, 69.2, and 38.5% respectively). Conclusions: The 3-4-50, Max T-Bili, and 50-50 criterion were all useful for predicting PHLF-related mortality after Hx with EBDR for PHCC.

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Surgery for hilar cholangiocarcinoma: The Leeds experience

Cited by 110 publications

References 43 publications

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

A new prognostic scoring system using factors available preoperatively to predict survival after operative resection of perihilar cholangiocarcinoma

Low rate of active treatment of patients with hilar cholangiocarcinoma

Postoperative Liver Failure Criteria for Predicting Mortality after Major Hepatectomy with Extrahepatic Bile Duct Resection

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