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Updated: Oct 23, 2025

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Conversion surgery for initially unresectable extrahepatic biliary tract cancer.

Moon Young Oh1, Hongbeom Kim1, Yoo Jin Choi1

  • 1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, Seoul National University College of Medicine, Seoul, Korea.

Annals of Hepato-Biliary-Pancreatic Surgery
|August 17, 2021
PubMed
Summary

Conversion surgery after chemotherapy offers a viable treatment option for initially unresectable biliary tract cancers. This approach may improve survival outcomes compared to palliative chemotherapy alone.

Keywords:
Biliary tract neoplasmsChemoradiotherapyOperative surgical procedures

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Gastroenterology

Background:

  • Biliary tract cancers (BTCs) are primarily treated with surgical resection for curative intent.
  • Most BTC patients present with unresectable disease, necessitating palliative chemotherapy.
  • Advancements in chemotherapy have enabled new treatment strategies like conversion surgery.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of conversion surgery for initially unresectable BTCs.
  • To assess the role of neoadjuvant chemotherapy in facilitating surgical resection for advanced BTCs.

Main Methods:

  • Retrospective review of patients with unresectable BTCs treated with conversion surgery post-chemotherapy (2013-2019).
  • Analysis of patient demographics, tumor types, chemotherapy regimens, and survival data.

Main Results:

  • Twelve patients underwent conversion surgery for unresectable BTCs (perihilar cholangiocarcinoma, distal CBD cancer, gallbladder cancer).
  • All patients received gemcitabine-based chemotherapy regimens.
  • Median overall survival was 28 months, exceeding historical controls for palliative chemotherapy alone.

Conclusions:

  • Conversion surgery is a potential therapeutic option for select unresectable BTC patients.
  • Neoadjuvant chemotherapy can downsize tumors, expanding surgical candidacy.
  • Further research is needed to optimize chemotherapy regimens for conversion surgery in BTC.