Surgical outcomes of 230 resected hilar cholangiocarcinoma in a single centre.

Abstract

BACKGROUND:

Low resectability rate and poor survival outcomes after surgical resection for hilar cholangiocarcinoma are common in most institutions. We retrospectively reviewed the surgical outcomes of hilar cholangiocarcinoma in a tertiary institution focusing on the surgical procedures, radicalities, survival rates and independent prognostic factors.

METHODS:

Two hundred thirty patients who underwent surgical resection for hilar cholangiocarcinoma between 1995 and 2010 were retrospectively analysed based on the clinical variables, Bismuth-Corlette types, radicality of operation and survival rates.

RESULTS:

The median overall and disease-free survival time in the whole cohort were 39.1 and 19.2 months, respectively. Patients with type I or II tumour were more likely to undergo segmental bile duct resection than combined liver resection with lower R0 rates (68.2% and 76.1%, respectively). Liver resection (P < 0.001) and combined caudate lobectomy (P = 0.003) were associated with significantly higher R0 rates. Multivariate analysis showed that lymph node metastasis (P = 0.001), preoperative level of bilirubin above 3.0 mg/dL (P = 0.003) and positive resection margin (P = 0.033) were independent prognostic factors on overall survival.

CONCLUSION:

Liver resection and combined caudate lobectomy increased curative resection rates in hilar cholangiocarcinoma regardless of Bismuth-Corlette types. Preoperative biliary drainage should be performed in jaundiced patients to improve perioperative outcome and survival.

• Authors: Sun Choon Song, Dong Wook Choi, Alfred Wei-Chieh Kow, Seong Ho Choi, Jin Seok Heo, Woo Seok Kim, Min Jung Kim
• Journal: ANZ journal of surgery (ANZ J Surg) Vol. 83 Issue 4 Pg. 268-74 (Apr 2013) ISSN: 1445-2197 [Electronic] Australia
• PMID: 22943422 (Publication Type: Journal Article)
• Copyright: © 2012 The Authors. ANZ Journal of Surgery © 2012 Royal Australasian College of Surgeons.

Topics

• Bile Duct Neoplasms (diagnosis, pathology, surgery)
• Bile Ducts, Intrahepatic
• Chi-Square Distribution
• Cholangiocarcinoma (diagnosis, pathology, surgery)
• Diagnostic Imaging
• Female
• Hepatectomy (methods)
• Humans
• Male
• Middle Aged
• Neoplasm Invasiveness
• Neoplasm Staging
• Pancreaticoduodenectomy (methods)
• Prognosis
• Proportional Hazards Models
• Retrospective Studies
• Survival Rate
• Treatment Outcome