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Journal of Hepato-Biliary-Pancreatic Sciences
Published in: Journal of Hepato-Biliary-Pancreatic Sciences 4/2010

01-07-2010 | Topics

Major hepatectomy for perihilar cholangiocarcinoma

Authors: Michiaki Unno, Yu Katayose, Toshiki Rikiyama, Hiroshi Yoshida, Kuniharu Yamamoto, Takanori Morikawa, Hiroki Hayashi, Fuyuhiko Motoi, Shinichi Egawa

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 4/2010

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Abstract

Background/purpose

Hilar cholangiocarcinoma and intrahepatic cholangiocarcinoma involving the hepatic hilus are defined as “perihilar cholangiocarcinoma”. The principle of surgical treatment is hemi-hepatectomy or trisectionectomy of the liver, caudate lobectomy, and resection of the extrahepatic bile duct for complete resection of the tumor. The aim of this study was to review the outcomes of major hepatectomy for perihilar cholangiocarcinoma.

Methods

Using the Kaplan–Meier method and the Cox proportional hazards model, we analyzed the results in 125 patients with perihilar cholangiocarcinoma who had undergone major hepatectomy.

Results

Right hepatectomy, right trisectionectomy, left hepatectomy, and left trisectionectomy were performed in 66, 8, 49, and 2 patients, respectively. Curative resection was achieved in 79 patients (63.2%). Mortality and morbidity rates were 8.0 and 48.7%, respectively. The overall 1-, 3-, and 5-year survival rates of all patients were 73.2, 36.7, and 34.7%, respectively. The median survival was 26.8 months. Multivariate analysis showed that the independent prognostic factors for overall survival were gender, histopathological grading, curative resection, and American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) pT.

Conclusions

Major hepatectomy for perihilar cholangiocarcinoma was acceptable and showed satisfactory outcomes. For long-term survival in these patients, the surgeon should aim for complete resection of the tumor with negative margins.
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Metadata
Title
Major hepatectomy for perihilar cholangiocarcinoma
Authors
Michiaki Unno
Yu Katayose
Toshiki Rikiyama
Hiroshi Yoshida
Kuniharu Yamamoto
Takanori Morikawa
Hiroki Hayashi
Fuyuhiko Motoi
Shinichi Egawa
Publication date
01-07-2010
Publisher
Springer Japan
Published in
Journal of Hepato-Biliary-Pancreatic Sciences / Issue 4/2010
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI
https://doi.org/10.1007/s00534-009-0206-3

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