Surgical management of proximal bile duct cancer: extended right lobe resection increases resectability and radicality

Neuhaus, P.; Jonas, Sven; Settmacher, Utz; Thelen, Armin; Benckert, Christoph; Lopez-Hänninen, E.; Hintze, R. E.

doi:10.1007/s00423-003-0383-5

Cited by 142 publications

(119 citation statements)

References 22 publications

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“…Several strategies have been developed to improve outcomes. One such strategy is partial hepatic resection with concomitant en-bloc resection of vascular structures and accompanied by reconstruction along with biliary excision for complex hilar tumors (60,67). Indeed, even in patients with BismuthCorlette Stage II tumors involving the confluence of the right and left hepatic ducts, caudate lobe resection is recommended because the bile ducts from the caudate lobe drain directly into the confluence and cancer frequently extends up these ducts into the caudate lobe.…”

Section: Therapy Curative Surgical Resectionmentioning

confidence: 99%

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

Malhi

Gores

2006

Journal of Hepatology

243

193

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Cholangiocarcinomas are tumors that arise anywhere in the biliary tract, presumably of cholangiocyte origin. The global incidence of this rare disease is on the rise. Several known risk factors exist, and link chronic biliary inflammation to the pathogenesis of cholangiocarcinoma. Among these, amplification of the epidermal growth factor receptor, the interleukin-6 signaling pathway, inducible nitric oxide, erb-2, and cyclooxygenase-2 are well defined. Most patients present late, with a median survival of months. Although, imaging studies and clinical context often indicate cholangiocarcinoma, pathologic and cytologic diagnosis is difficult to obtain. Advanced cytologic tests with fluorescent in situ hybridization or digital image analysis can increase diagnostic sensitivity. Surgical resection is the current therapy of choice for both intrahepatic and ductal cholangiocarcinomas. However, the 5 year survival is poor, with 60 to greater than 90% recurrence rates. In a single center experience, liver transplantation with neoadjuvant chemoirradiation, for highly selected patients has a 5 year disease free survival of greater than 80%. Future targeted therapies will depend on a better understanding of the cellular and molecular biology of cholangiocarcinomas.

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Section: Therapy Curative Surgical Resectionmentioning

confidence: 99%

Cholangiocarcinoma: Modern advances in understanding a deadly old disease

Malhi

Gores

2006

Journal of Hepatology

243

193

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“…It was recently reported that aggressive surgical strategies in the treatment of ICC can significantly increase the survival of ICC patients [14,80,81] . Yamamoto et al [82] and Ohashi et al [83] suggested that anatomic and extensive hepatectomy is the rational procedure for mass-forming ICC, while hepatectomy with extrahepatic duct excision, and hilar lymph nodal resection is the rational procedure for infiltrating ICC.…”

Section: Hepatectomymentioning

confidence: 99%

Current status of intrahepatic cholangiocarcinoma

Yang¹,

Yan²

2008

WJG

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Intrahepatic cholangiocarcinoma (ICC) is a rare primary liver cancer with a global increasing trend in recent years. Symptoms tend to be vague and insidious in development, often are diagnosed at an advanced stage when only palliative approaches can be used with a median survival rate of months. Comparing with HCC, ICC tends to spread to lymph nodes early, and is rarely limited to the regional lymph nodes, with a frequent postoperative recurrence. Surgery is the only choice of curative therapy for ICC, but recently no consensus has been established for operation. Thus, more data from multiple centers and more cases are needed. Generally speaking, current adjunctive therapy cannot clearly improve survival. Further research is needed to find more effective radio-and chemotherapeutic regimens.

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“…предложили новую методику достижения радикального хирургическо-го лечения перихилярной холангиокарциномы [31,32]. Это так называемая hilar en block резекция, или non-touch техника, включающая в себя расширен-ную правостороннюю трисекциоэктомию (Sg 1, 4-8), резекцию бифуркации воротной вены, резек-цию правой печеночной артерии и внепеченочных желчных протоков.…”

Section: îáñóAeäåíèåunclassified