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Hepatic hilar bile duct cancer treated by multidisciplinary approach *
Author(s) -
Tanaka Junichi,
Sato Yasuhiko,
Asanuma Yoshihiro,
Koyama Kenji
Publication year - 1994
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/bf02391077
Subject(s) - medicine , bile duct cancer , bile duct , percutaneous , biliary drainage , surgery , radiology
The effects of a multidisciplinary approach in the treatment of hepatic hilar bile duct cancer were evaluated in 24 of 31 resected patients operated from 1985 through 1992. Our multidisciplinary treatment included preoperative biliary drainage, hepatic hilar resection with hepatic portajejunostomy, intraoperative targeting chemotherapy, and postoperative intracavitary irradiation, using a remote after loading system. Before surgical resection, percutaneous transhepatic biliary drainage was performed in patients with hyperbilirubinemia to reduce their serum bilirubin level and to improve hepatic function. Six patients underwent pancreatoduodenectomy, due to cancer invasion, in addition to hepatic hilar resection. Postoperative intracavitary irradiation with 60 Co was performed via bile duct and inferior vena cava. There were no serious postoperative complications or postoperative deaths among patients treated by our multidisciplinary approach. The overall 1‐, 2‐, and 5‐year survival rates were 71%, 58%, and 24%, respectively. In curatively resected patients, the 1‐, 2‐, and 5‐year survival rates were 100%, 80% and 53%, respectively. These results demonstrate that our multidisciplinary therapeutic modality gives better survival rates than those reported previously.