[Surgical resection with curative intent of hilar cholangiocarcinoma. Our experience]
Hernán Vaccarezza1, Victoria Ardiles, Nicolás Resio
1Servicio de Cirugía General, Sector de Cirugía HPB y Trasplante Hepático, Hospital Italiano de Buenos Aires, Argentina.
Introduction:
Surgery is the treatment of choice for hilar cholangiocarcinoma (HCC). Obtaining tumor-free margins (RO resection) has been reported as the only prognostic factor associated with increased survival. The aim of this study was to analyze a consecutive series of patients operated with curative intent over a 14-year period.
Material And Methods:
This is a retrospective study of patients operated with curative intent between 1994 and 2008. Hepatic resection was associated with resection of segment 1, extrahepatic bile duct and lymph node dissection in all cases.
Results:
40 patients, 62% male with a mean age of 58.2 years. Jaundice was the most common presenting symptom (70%). Biliary confluence was compromised in 62% oftumors. Thirty-nine patients underwent major hepatectomy with 95% RO resections and 6 associated vascular resections. Postoperative morbidity was 37.5% and mortality 10%. Overall survival and disease-free survival at 1, 3 and 5 years was 88% and 63%, 55% and 34%, and 43% and 24%, respectively.
Conclusion:
The association of major hepatectomy with caudate lobe resection and vascular resection when needed, was associated with 95% tumor-free margin and morbidity and mortality rate according to the standards of the international literature. While it is necessary a greater number of cases, associated vascular resection seems to be a feasible and safe option in the treatment of locally advanced HCC.