Major hepatectomy for perihilar cholangiocarcinoma
Related Experiment Video
Updated: Jun 18, 2026
Complete Laparoscopic Radical Resection of Perihilar Cholangiocarcinoma Type IIIb
Published on: January 17, 2025
Michiaki Unno1, Yu Katayose, Toshiki Rikiyama
1Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, Tohoku University Graduate School of Medicine, 1-1 Seiryo-machi, Aoba-ku, Sendai 980-8574, Japan. m_unno@surg1.med.tohoku.ac.jp
Insights
Major hepatectomy is a viable treatment for perihilar cholangiocarcinoma, offering acceptable outcomes. Achieving complete tumor resection with negative margins is crucial for long-term survival in these patients.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Perihilar cholangiocarcinoma involves tumors at the hepatic hilus.
- Surgical treatment principles include liver resection (hemi-hepatectomy, trisectionectomy), caudate lobectomy, and extrahepatic bile duct resection.
Purpose of the Study:
- To review the outcomes of major hepatectomy for perihilar cholangiocarcinoma.
Main Methods:
- Analysis of 125 patients who underwent major hepatectomy for perihilar cholangiocarcinoma.
- Kaplan-Meier method and Cox proportional hazards model were used for statistical analysis.
Main Results:
- Curative resection was achieved in 63.2% of patients.
- Overall 1-, 3-, and 5-year survival rates were 73.2%, 36.7%, and 34.7%, respectively.
- Independent prognostic factors for survival included gender, histopathological grading, curative resection, and AJCC/UICC pT stage.
Conclusions:
- Major hepatectomy is an acceptable surgical approach for perihilar cholangiocarcinoma with satisfactory outcomes.
- Complete tumor resection with negative margins is essential for improving long-term survival.
Background/Purpose:
Hilar cholangiocarcinoma and intrahepatic cholangiocarcinoma involving the hepatic hilus are defined as "perihilar cholangiocarcinoma". The principle of surgical treatment is hemi-hepatectomy or trisectionectomy of the liver, caudate lobectomy, and resection of the extrahepatic bile duct for complete resection of the tumor. The aim of this study was to review the outcomes of major hepatectomy for perihilar cholangiocarcinoma.
Methods:
Using the Kaplan-Meier method and the Cox proportional hazards model, we analyzed the results in 125 patients with perihilar cholangiocarcinoma who had undergone major hepatectomy.
Results:
Right hepatectomy, right trisectionectomy, left hepatectomy, and left trisectionectomy were performed in 66, 8, 49, and 2 patients, respectively. Curative resection was achieved in 79 patients (63.2%). Mortality and morbidity rates were 8.0 and 48.7%, respectively. The overall 1-, 3-, and 5-year survival rates of all patients were 73.2, 36.7, and 34.7%, respectively. The median survival was 26.8 months. Multivariate analysis showed that the independent prognostic factors for overall survival were gender, histopathological grading, curative resection, and American Joint Committee on Cancer (AJCC)/International Union Against Cancer (UICC) pT.
Conclusions:
Major hepatectomy for perihilar cholangiocarcinoma was acceptable and showed satisfactory outcomes. For long-term survival in these patients, the surgeon should aim for complete resection of the tumor with negative margins.
