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01-03-2013

One-stage Resection for Bismuth Type IV Hilar Cholangiocarcinoma with High Hilar Resection and Parenchyma-preserving Strategies: A Cohort Study

Authors: Jing Wang Tan, Ben Shun Hu, Ya Juan Chu, Yun Chang Tan, Xu Ji, Ke Chen, Xiang Min Ding, Aiqun Zhang, Fei Chen, Jia Hong Dong

Published in: World Journal of Surgery | Issue 3/2013

Abstract

Background

Bismuth type IV hilar cholangiocarcinoma (HC) tumors are usually considered unresectable. The strategies of high hilar resection while preserving liver parenchyma can achieve potentially one-stage curative resection for this condition. The aim of the present study was to investigate the feasibility and safety of available strategies.

Methods

Fifty-one consecutive patients with bismuth type IV HC who underwent one-stage resection were retrospectively reviewed with regard to curative resection rate, remnant liver volume, morbidity, mortality, and survival time.

Results

The total median survival time was 29 months. The R₀ (curative resection) rate was 57.8 %. The ratio of the remnant liver volume (RLV) to the standard liver volume (SLV) ranged from 35.0 to 60.6 %, with a mean of 44.5 %. The in-hospital mortality and morbidity rates were 3.9 and 37.2 %, respectively. In the R₀ patients’ survival, there was not a significant difference between bilioenteric anastomosis and hepatoenteric anastomosis (P = 0.714).

Conclusions

Combined caudate lobe and high hilar resection (CCHR) is technically safe and oncologically justifiable and could be adopted with a high cure rate as a one-stage resection procedure for most patients with Bismuth type IV HC whose total bilirubin level is less than 20 mg/L and whose direct bilirubin is more than 60 % of total bilirubin.

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Title: One-stage Resection for Bismuth Type IV Hilar Cholangiocarcinoma with High Hilar Resection and Parenchyma-preserving Strategies: A Cohort Study
Authors: Jing Wang Tan
Ben Shun Hu
Ya Juan Chu
Yun Chang Tan
Xu Ji
Ke Chen
Xiang Min Ding
Aiqun Zhang
Fei Chen
Jia Hong Dong
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: World Journal of Surgery / Issue 3/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-012-1878-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

One-stage Resection for Bismuth Type IV Hilar Cholangiocarcinoma with High Hilar Resection and Parenchyma-preserving Strategies: A Cohort Study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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