Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoya experience (original) (raw)

Abstract:

From 1977 to 1997, surgical resection was possible in 142 (80%) of 177 patients with hilar cholangiocarcinoma after relieving jaundice by single or multiple percutaneous transhepatic biliary drainage followed by percutaneous transhepatic cholangioscopy and/or percutaneous trans-hepatic portal vein embolization. Curative resection was possible in 108 (61%) of the 142 patients, and 100 of these patients underwent various types of hepatectomy with caudate lobectomy for a 30-day operative mortality rate of 6% and 9% hospital mortality. Combined portal vein resection was carried out in 43 cases including 41 hepatectomies and 2 bile duct resections. Hepatopancreatoduodenectomy was performed in 16 patients. Cancer recurrence was observed in 58 of the 108 patients undergoing curative resection. The 3-, 5-, and 10-year survival rates for 100 patients undergoing curative hepatectomy and 8 with curative bile duct resection were 43%, 26%, and 19%; and 31%, 16%, and 0%, respectively; those for 40 patients with positive lymph node metastasis, 84 with perineural invasion, and 43 with combined portal vein resection were 27%, 14%, and 7%; 34%, 21%, and 13%; and 18%, 6%, and 0%, respectively. These survival rates are significantly better than those for 35 patients with unresectable cancer. Curative resection after aggressive preoperative management is recommended as a reasonable surgical approach to hilar cholangiocarcinoma.

Similar content being viewed by others

Author information

Authors and Affiliations

  1. First Department of Surgery, Nagoya University School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya 466-8550, Japan, , , , , , JP
    Yuji Nimura, Junichi Kamiya, Satoshi Kondo, Masato Nagino, Katsuhiko Uesaka, Koji Oda, Tsuyoshi Sano, Hideo Yamamoto & Naokazu Hayakawa

Authors

  1. Yuji Nimura
  2. Junichi Kamiya
  3. Satoshi Kondo
  4. Masato Nagino
  5. Katsuhiko Uesaka
  6. Koji Oda
  7. Tsuyoshi Sano
  8. Hideo Yamamoto
  9. Naokazu Hayakawa

Additional information

Received for publication on Aug. 23, 1999; accepted on Nov. 29, 1999

About this article

Cite this article

Nimura, Y., Kamiya, J., Kondo, S. et al. Aggressive preoperative management and extended surgery for hilar cholangiocarcinoma: Nagoya experience.J Hep Bil Pancr Surg 7, 155–162 (2000). https://doi.org/10.1007/s005340050170

Download citation