Surgical treatment for intrahepatic cholangiocarcinoma

Abstract

Despite surgical treatment for intrahepatic cholangiocarcinoma (ICC) becoming more widely available, the prognosis after hepatic resection for ICC remains poor. Because ICC is relatively rare, the TNM staging system for ICC was finally established in the 2000s. Resection margin status and lymph node metastases are important prognostic factors after surgery for ICC; however, the true impact of wide resection margins or lymph node dissection on postoperative survival is unclear. Although adjuvant chemotherapy can improve the postoperative prognosis of patients with various types of cancer, no standard regimen has been developed for ICC. Over 50 % of patients suffer postoperative recurrence, even after curative resection, and no effective treatment for recurrent ICC has been established. Therefore, despite advances in imaging studies and hepatobiliary surgery, significant challenges remain in improving the prognosis of patients with ICC.

Outcomes after resection of occupational cholangiocarcinoma

“…Surgical resection is a curative treatment for cholangiocarcinoma [19,20]. However, surgical treatments have been performed in only 22 of the 37 patients with occupational cholangiocarcinoma because the stage of the cholangiocarcinoma was too advanced at the diagnosis in the other 15 patients.…”

“…Pathological examination of the large bile ducts could not be performed in three patients (patient no. [18][19][20] because these patients underwent pancreaticoduodenectomy.…”

“…9), pancreatic fistula in three patients (patient no. 5,19,20), chylous ascites in two patients (patient no. 8,16), and refractory ascites in one patient (patient no.…”

“…Postoperatively, intraabdominal infection developed in nine patients (patient no. 1,2,4,5,9,12,14,19,20), anastomotic leakage of the hepaticojejunostomy in three patients (patient no. 5,11,20), bile leakage developed in one patient (patient no.…”

“…18) and from the common hepatic artery in one patient (patient no. 19). In one patient, re-operation and stenting was performed for portal vein thrombosis (patient no.…”