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Surgical outcomes of 230 resected hilar cholangiocarcinoma in a single centre
Author(s) -
Song Sun Choon,
Choi Dong Wook,
Kow Alfred WeiChieh,
Choi Seong Ho,
Heo Jin Seok,
Kim Woo Seok,
Kim Min Jung
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/j.1445-2197.2012.06195.x
Subject(s) - medicine , perioperative , hepatectomy , surgery , resection , survival rate , bile duct , retrospective cohort study , multivariate analysis , overall survival
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, B ismuth‐ C orlette 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 R 0 rates (68.2% and 76.1%, respectively). Liver resection ( P < 0.001) and combined caudate lobectomy ( P = 0.003) were associated with significantly higher R 0 rates. Multivariate analysis showed that lymph node metastasis ( P = 0.001), preoperative level of bilirubin above 3.0 mg/d L ( 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 B ismuth‐ C orlette types. Preoperative biliary drainage should be performed in jaundiced patients to improve perioperative outcome and survival.