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Journal of Gastrointestinal Surgery

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01-07-2015 | Original Article

Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?

Authors: Francesca Ratti, Federica Cipriani, Guglielmo Piozzi, Marco Catena, Michele Paganelli, Luca Aldrighetti

Published in: Journal of Gastrointestinal Surgery | Issue 7/2015

Abstract

Background

Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinoma patients and compared short- and long-term outcomes of left- and right-sided resections.

Methods

One hundred and five patients out of 124 diagnosed with Klatskin tumors underwent major liver resection. Sixty-one patients underwent right-sided resections (right group), whereas 44 underwent left-sided resections (left group). Perioperative morbidity, perioperative mortality, and overall and disease-free survival were compared between the groups.

Results

Morbidity and mortality were higher in the right group (59 and 8.2 %, respectively) than in the left group (38.6 and 2.3 %, respectively) (p < 0.005). The most frequent cause of death was liver failure. The R0 rate was 75.4 % in the right and 61.4 % in the left group. The 5-year survival rate was 42.8 % in the right and 35.3 % in the left group (p < 0.05). Patients in the left group more frequently developed local recurrence (87 vs. 69 % in the right group).

Conclusion

Lesion side impacts outcome: right resections still cause significant morbidity related to extensive parenchymal sacrifice but are associated with better long-term survival because right hepatic pedicle resection enables better radicality compared with left resections.

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Title: Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?
Authors: Francesca Ratti
Federica Cipriani
Guglielmo Piozzi
Marco Catena
Michele Paganelli
Luca Aldrighetti
Publication date: 01-07-2015
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 7/2015
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-015-2840-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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