The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma: A retrospective cohort study

Hong, Yongseok; Choi, Sae Byeol; Lee, K. H.; Park, S. W.; Park, Y. N.; Choi, Jin Sub; Lee, W. J.; Chung, Jae Bock; Kim, Kyung Sik

doi:10.1016/j.ejso.2010.12.010

Cited by 20 publications

(14 citation statements)

References 25 publications

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“…The surgical techniques become more sophisticated, and have been aided by the incorporation of extended lobectomy, vascular reconstruction, and preoperative portal vein embolisation. 110–112 This final procedure promotes hypertrophy of the uncompromised liver lobe and increases liver remnant volume. The success of the approach is often dependent on vascular anatomy.…”

Section: Perihilar Cholangiocarcinomamentioning

confidence: 99%

Cholangiocarcinoma

Razumilava¹,

Gores²

2014

The Lancet

1,465

1,314

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Cholangiocarcinoma represents a diverse group of epithelial cancers united by late diagnosis and poor outcomes. Specific diagnostic and therapeutic approaches are undertaken for cholangiocarcinomas of different anatomical locations (intrahepatic, perihilar, and distal). Mixed hepatocellular cholangiocarcinomas have emerged as a distinct subtype of primary liver cancer. Clinicians need to be aware of intrahepatic cholangiocarcinomas arising in cirrhosis and properly assess liver masses in this setting for cholangiocarcinoma. Management of biliary obstruction is obligatory in perihilar cholangiocarcinoma, and advanced cytological tests such as fluorescence in-situ hybridisation for aneusomy are helpful in the diagnosis. Liver transplantation is a curative option for selected patients with perihilar but not with intrahepatic or distal cholangiocarcinoma. International efforts of clinicians and scientists are helping to identify the genetic drivers of cholangiocarcinoma progression, which will unveil early diagnostic markers and direct development of individualised therapies.

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Section: Perihilar Cholangiocarcinomamentioning

confidence: 99%

Cholangiocarcinoma

Razumilava¹,

Gores²

2014

The Lancet

1,465

1,314

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“…However, many reports show low mortality (0–2%) even after invasive surgery, such as right hepatectomy and trisectionectomy. On the other hand, the high mortalities (10–21%) after radical resection of bile tract cancers with extended hepatectomy are often reported from the institutes that limit the indication of PVE only in cases with comparably small future remnant liver volume (25–30%) . Taking these facts into account, PVE is supposed to have benefits on such radical surgery for bile duct cancers.…”

Section: Cq17: Which Patients With Biliary Tract Cancer Should Be Conmentioning

confidence: 99%

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Miyazaki

Yoshitomi

Miyakawa³

et al. 2015

J Hepato Biliary Pancreat

234

165

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Background The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract and ampullary carcinomas in 2008. Novel treatment modalities and handling of clinical issues have been proposed after the publication. New approaches for editing clinical guidelines, such as the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system, also have been introduced for better and clearer grading of recommendations. Methods Clinical questions (CQs) were proposed in seven topics. Recommendation, grade of recommendation and statement for each CQ were discussed and finalized by evidencebased approach. Recommendation was graded to grade 1 (strong) and 2 (weak) according to the concept of GRADE system. Results The 29 CQs covered seven topics: (1) prophylactic treatment, (2) diagnosis, (3) biliary drainage, (4) surgical treatment, (5) chemotherapy, (6) radiation therapy, and (7) pathology. In 27 CQs, 19 recommendations were rated strong and 11 recommendations weak. Each CQ included the statement of how the recommendation was graded. Conclusions This guideline provides recommendation for important clinical aspects based on evidence. Future collaboration with cancer registry will be a key for assessment of the guidelines and establishment of new evidence. Free full-text articles and a mobile application of this guideline are available via

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“…PHLF tended to occur more frequently in the RH group than in the LH group (21.2% vs. 8.3%) but the difference was not statistically significant. A small FLR volume associated with severe PHLF is one of the essential considerations in planning surgical strategy [29, 30]. We focused on two ways to prevent PHLF in RH for hilar cholangiocarcinoma, namely, the aggressive use of preoperative biliary drainage for FLR, and PVE.…”

Section: Discussionmentioning

confidence: 99%

Right-side versus left-side hepatectomy for the treatment of hilar cholangiocarcinoma: a comparative study

Kim

et al. 2020

World J Surg Onc

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BackgroundRadical resection is the only curative treatment for patients with hilar cholangiocarcinoma. While left-side hepatectomy (LH) may have an oncological disadvantage over right-side hepatectomy (RH) owing to the contiguous anatomical relationship between right hepatic inflow and biliary confluence, a small future liver remnant after RH could cause worse surgical morbidity and mortality. We retrospectively compared surgical morbidity and long-term outcome between RH and LH to determine the optimal surgical strategy for the treatment of hilar cholangiocarcinoma.MethodsThis study considered 83 patients who underwent surgical resection for hilar cholangiocarcinoma between 2010 and 2017. Among them, 57 patients undergoing curative-intent surgery including liver resection were enrolled for analysis—33 in the RH group and 27 in the LH group. Prospectively collected clinicopathologic characteristics, perioperative outcomes, and long-term survival were evaluated.ResultsPortal vein embolization was more frequently performed in the RH group than in the LH group (18.2% vs. 0%, P = 0.034). The proportion of R0 resection was comparable in both groups (75.8% vs. 75.0%, P = 0.948). The 5-year overall and recurrence-free survival rates did not differ between the groups (37.7% vs. 41.9%, P = 0.500, and 26.3% vs. 33.9%, P = 0.580, respectively). The side of liver resection did not affect long-term survival. In multivariate analysis, transfusion (odds ratio, 3.12 [1.42–6.87], P = 0.005) and post-hepatectomy liver failure (≥ grade B, 4.62 [1.86–11.49], P = 0.001) were independent risk factors for overall survival.ConclusionsWe recommend deciding the side of liver resection according to the possibility of achieving radical resection considering the anatomical differences between RH and LH.

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The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma: A retrospective cohort study

Cited by 20 publications

References 25 publications

Cholangiocarcinoma

Cholangiocarcinoma

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition

Right-side versus left-side hepatectomy for the treatment of hilar cholangiocarcinoma: a comparative study

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The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma: A retrospective cohort study

Cited by 20 publications

References 25 publications

Cholangiocarcinoma

Cholangiocarcinoma

Clinical practice guidelines for the management of biliary tract cancers 2015: the 2nd English edition

Right-side versus left-side hepatectomy for the treatment of hilar cholangiocarcinoma: a comparative study

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Clinical practice guidelines for the management of biliary tract cancers 2015: the 2^nd English edition