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Liver Resection for Bismuth Type I and Type II Hilar Cholangiocarcinoma

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Abstract

Background

In patients with Bismuth type I and II hilar cholangiocarcinoma (HCCA), bile duct resection alone has been the conventional approach. However, many authors have reported that concomitant liver resection improved surgical outcomes.

Methods

Between January 2000 and January 2012, 52 patients underwent surgical resection for a Bismuth type I and II HCCA (type I: n = 22; type II: n = 30). Patients were classified into two groups: concomitant liver resection (n = 26) and bile duct resection alone (n = 26).

Results

Bile duct resection alone was performed in 26 patients. Concomitant liver resection was performed in 26 patients (right side hepatectomy [n = 13]; left-side hepatectomy [n = 6]; volume-preserving liver resection [n = 7]). All liver resections included a caudate lobectomy. Patient and tumor characteristics did not differ between the two groups. Although concomitant liver resection required longer operating time (P < 0.001), it had a similar postoperative complication rate (P = 0.764), high curability (P = 0.010), and low local recurrence rate (P = 0.006). Concomitant liver resection showed better overall survival (P = 0.047).

Conclusions

Concomitant liver resection should be considered in patients with Bismuth type I and II HCCA.

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Authors and Affiliations

  1. Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, Seoul, 120-75, Korea

    Jin Hong Lim, Gi Hong Choi, Sung Hoon Choi, Kyung Sik Kim, Jin Sub Choi & Woo Jung Lee

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  1. Jin Hong Lim
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  2. Gi Hong Choi
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  3. Sung Hoon Choi
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Correspondence to Gi Hong Choi.

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Lim, J.H., Choi, G.H., Choi, S.H. et al. Liver Resection for Bismuth Type I and Type II Hilar Cholangiocarcinoma. World J Surg 37, 829–837 (2013). https://doi.org/10.1007/s00268-013-1909-9

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