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Surgical management of perihilar cholangiocarcinoma: a K hon K aen experience
Author(s) -
Khuntikeo Narong,
Pugkhem Ake,
Titapun Attapol,
Bhudhisawasdi Vajarabhongsa
Publication year - 2014
Publication title -
journal of hepato‐biliary‐pancreatic sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 1868-6974
DOI - 10.1002/jhbp.74
Subject(s) - medicine , obstructive jaundice , biliary drainage , perioperative , klatskin tumor , gastroenterology , jaundice , general surgery , surgery , resection
Cholangiocarcinoma is the most common cancer in the northeast of T hailand. Most of the patients present when the disease is in an advanced stage. Improvement of preoperative diagnoses and surgical techniques provide more satisfactory results. Herein we reviewed our 30‐year experience in management of perihilar cholangiocarcinoma in K hon K aen northeast T hailand. Between 1982 and 2012 we reviewed four specific studies of perihilar cholangiocarcinoma in S rinagarind H ospital, K hon K aen, T hailand. The first study focused on advanced surgical pathology and palliative surgery, which were used to treat obstructive jaundice cholangiocarcinoma patients. Long‐term survival in this study was rare with a one‐year survival of just 15%. The second study was conducted on 30 consecutive cases of perihilar cholangiocarcinoma who presented with obstructive jaundice without preoperative biliary drainage. All the patients underwent major liver resection with bilio‐enteric reconstruction. Perioperative mortality was 6.7% without a 5‐year survival. The third study aimed to analyze the survival rates and factors affecting survival in extrahepatic CCA patients following surgical treatment at S rinagarind H ospital and concluded that resection margins are an important prognostic factor. The last study objective was the analysis of curative surgical attempt in 99 consecutive perihilar cholangiocarcinoma and results showed that R 0 resection could improve long‐term survival. We evaluated four studies of perihilar cholangiocarcinoma in S rinagarind H ospital, K hon K aen, T hailand from 1982–2012. Viewed chronologically there has been a progressive improvement of diagnosis and surgical treatment during the past 30 years. Despite these advances the 5‐year survival rate remains unsatisfactorily low. Future improvement of patient selection and surgical techniques can lead to a greater survival rate for patients.