Surgical Treatment Of Hilar And Intrahepatic Cholangiocarcinoma Pdf

surgical treatment of hilar and intrahepatic cholangiocarcinoma pdf

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Cholangiocarcinoma 2020: the next horizon in mechanisms and management

Javascript is currently disabled in your browser. Several features of this site will not function whilst javascript is disabled. Received 21 November Published 22 February Volume Pages — Review by Single anonymous peer review. Editor who approved publication: Dr Faris Farassati. It arises from the peripheral bile ducts within the liver parenchyma, proximal to the secondary biliary radicals.

Complete resection remains the only potentially curative therapy for biliary tract cancers BTC. Unfortunately, patients most commonly present with unresectable or metastatic disease, and recurrence rates remain high after complete resection. This review focuses on the current surgical strategies in the management of BTCs including gallbladder cancer, intrahepatic, and extrahepatic cholangiocarcinoma. Gallbladder cancer typically presents one of three ways: I suspicion of malignancy preoperatively; II malignancy suspected intra-operatively; and III malignancy diagnosed incidentally following cholecystectomy. Incidental diagnosis of gallbladder cancer on final pathology following a cholecystectomy for suspected benign biliary disease is the most common presentation and is reported to occur following 0. Duffy et al.

Surgery for cholangiocarcinoma

Metrics details. Radical resection is the only curative treatment for patients with hilar cholangiocarcinoma. While left-side hepatectomy LH may have an oncological disadvantage over right-side hepatectomy RH owing to the contiguous anatomical relationship between right hepatic inflow and biliary confluence, a small future liver remnant after RH could cause worse surgical morbidity and mortality. We retrospectively compared surgical morbidity and long-term outcome between RH and LH to determine the optimal surgical strategy for the treatment of hilar cholangiocarcinoma. This study considered 83 patients who underwent surgical resection for hilar cholangiocarcinoma between and Among them, 57 patients undergoing curative-intent surgery including liver resection were enrolled for analysis—33 in the RH group and 27 in the LH group.


Keywords: Intrahepatic cholangiocarcinoma; Practice guidelines; Diagnosis and management. UK, the term hilar is used rather than Klatskin and most cancer registries to change the surgical management in up to 30% of patients.


Intrahepatic cholangiocarcinoma: current perspectives

Peri-hilar cholangiocarcinoma PHC or hilar cholangiocarcinoma HCCA characterizes a critical effort to assess significantly sick patients. The existing scenery and proof to the diagnosis and treatments for hilar cholangiocarcinoma are improving day by day. Patients with HCCA encounter numerous obstacles in acquiring efficient therapies. The initial signs and symptoms in many cases are non-specific, and in many patients the tumors are not resectable because of involvement of the perihilar structures.

Surgical management of biliary tract cancers

Skip to search form Skip to main content You are currently offline. Some features of the site may not work correctly. DOI: Guglielmi and A. Ruzzenente and C. Guglielmi , A. Ruzzenente , C.

Cholangiocarcinoma CCC is the most aggressive malignant tumor of the biliary tract. Besides its clinical presentation, a multimodal diagnostic approach should be carried on by a tertiary specialized center to avoid miss-diagnosis. Preoperative staging must consider the extent of liver resection to avoid post-surgical hepatic failure.


more radical surgery. This review focuses on the recent advances in surgical treatment cholangiocarcinoma is represented by intrahepatic, perihi- lar, or distal type in , but the entity of hilar cholangiocarcinoma was recognized only.


chapter and author info

Surgical resection is the only potentially curative treatment for patients with cholangiocarcinoma. This review addresses several challenges in surgical management of cholangiocarcinoma. The first challenge is diagnosis: a biopsy is typically avoided because of the risk of seeding metastases and the low yield of a brush of the bile duct. The second challenge is staging; even with the best preoperative imaging, a substantial percentage of patients has occult metastatic disease detected at staging laparoscopy or early recurrence after resection. The third challenge is an adequate volume and function of the future liver remnant, which may require preoperative biliary drainage and portal vein embolization. The fourth challenge is a complete resection: a positive bile duct margin is not uncommon because the microscopic biliary extent of disease may be more extensive than perceived on imaging. The sixth challenge is that even after a complete resection most patients develop recurrent disease.

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Request PDF | Surgical Treatment of Hilar and Intrahepatic Cholangiocarcinoma | Cholangiocarcinoma is the second most frequent primary.

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