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179582

Outcome of surgical resection for hilar cholangiocarcinoma

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Last updated: 23 Jan 2023

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Abstract

Background: Hilar  cholangiocarcinoma  (HC) is an adenocarcinoma  of the extrahepatic biliary tree arising  from the main left or right hepatic ducts or their confluence. HC is still considered to be a disease which is difficult to treat or to cure.  Its prognosis is very poor and the only curative treatment is complete resection with a negative surgical margin. Preoperative evaluation of the tumor is important in order to evaluate resectability and the extent of surgery. Surgical resection involves  either local resection, local excision  with caudate lobectomy or major hepatic resection with caudate lobectomy.The aim of this work was to study the feasibility and outcome of surgical resection  for hilar cholangiocarcinoma. Methods: This study was carried out on 72 patients with radiological evidence suggesting resectable hilar cholangiocarcinoma presented to the Gastrointestinal Surgery Unit, Main Alexandria University  Hospital  during  the period  from March 2006 till January  2013.   All patients'presentations, laboratory and radiological data, surgical procedures, complications, follow-up and survival data were collected Results:  Between March 2006 and January 2013; 72 patients  (56 males and 16 females) were admitted for resection of a radiologically suspected resectable hilar cholangiocarcinoma. All patients presented with obstructive jaundice of varying degrees. The tumors were Bismuth­ Corlette typelin36patients, typellin 24patients, type!Ilain 5patientsandtype!Ilbin 7patients. All patients underwent surgical resection. Forty-six patients underwent bile duct resection with hepaticoj([/unostomy and regionallymph node dissection. Fourteen patients underwent bile duct resection and lymph node dissection  with caudate lobectomy.  Three patients underwent right hepatectomy, two patients underwent extended right hepatectomy,  four patients underwent left hepatectomy and three patients underwent extended left hepatectomy;  all with hilar bile duct resection, caudate lobectomy and regional lymph node dissection. Complete resection (RO) was achieved in 65 patients {90.3%), while 7 patients  (9.7%) had incomplete resection. All over 9 patients  (12.5) developed recurrence. The 3 and 5-years overall survival rate  for all patients, using the Kaplan-Meier actuarial curve, were 51.4% and 34.7% respectively. Conclusion: Cholangiocarcinoma remains a devastating disease. Most patients have unresectable tumors at the time of diagnosis and have a dismal prognosis. Complete resection is the only treatment that offers any hope of long-term  survival but is possible in  few patients. Furthermore,  even after resection,  disease recurrence is common. Acfjuvant therapy has not been shown to have a role in this disease.

DOI

10.21608/asjs.2014.179582

Keywords

Bile duct cancer, hilar cholangiocarcinoma, Klatskin tumor, Staging, surgical resection

Authors

First Name

Magdy

Last Name

ASorour

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Affiliation

CIT Surgery Unit, General Surgery Department, University of Alexandria, Egypt.

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First Name

Mohamed T

Last Name

El-Riwini

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Affiliation

CIT Surgery Unit, General Surgery Department, University of Alexandria, Egypt.

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Volume

7

Article Issue

1

Related Issue

25657

Issue Date

2014-01-01

Receive Date

2021-06-23

Publish Date

2014-01-01

Page Start

1

Page End

14

Print ISSN

2090-7249

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https://asjs.journals.ekb.eg/article_179582.html

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https://asjs.journals.ekb.eg/service?article_code=179582

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11

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Original Article

Type Code

1,943

Publication Type

Journal

Publication Title

Ain Shams Journal of Surgery

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https://asjs.journals.ekb.eg/

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Article

Created At

23 Jan 2023