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Effect of mapping biopsy on surgical management of cholangiocarcinoma
Author(s) -
Yao Siyuan,
Taura Kojiro,
Okuda Yukihiro,
Kodama Yuzo,
Uza Norimitsu,
Gouda Naoki,
Minamiguchi Sachiko,
Okajima Hideaki,
Kaido Toshimi,
Uemoto Shinji
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25226
Subject(s) - medicine , biopsy , general surgery , radiology
Background The effect of endoscopic transpapillary mapping biopsy (MB) on decision‐making of surgical indications, selecting surgical procedures, or operative outcomes remains unclear. Methods Two‐hundred and thirty‐four patients with cholangiocarcinoma who were evaluated for surgical resection from 2007 to 2017 were reviewed. MB was performed in 80 patients who underwent tumor resection. We examined how MB affected operative indications or modified surgical procedures. Operative curability was compared between patients with and without preoperative MB. Results MB resulted in avoidance of noncurative resections in eight patients (14%, 8/57) of abandoned laparotomies. Based on the MB, surgical procedures were modified in nine patients (11.3%, 9/80), and this was justified by pathological examinations in eight patients (88.9%, 8/9). The MB group had an improved negative margin rate (83.8% vs 67.5%, P = 0.017) and a lower incidence of carcinoma in situ (8.8% vs 20.0%, P = 0.043) at the first cut than the non‐MB group. The incidence of bile leakage was significantly lower in the MB group in both anastomotic site (5.0% vs 16.3%, P = 0.018) and parenchymal surface (2.5% vs 10.0%, P = 0.043). Conclusion MB is helpful for selecting optimal surgical procedure for cholangiocarcinoma and it contributes for safe surgery by securing negative bile duct margin on the first cut.