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Major Hepatic Resection for Peri-hilar Biliary Cancers

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The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases

Abstract

Surgical resection remains the only potentially curative treatment for pCC but, given the tumor anatomical position and advances stage at diagnosis, surgery is still demanding with high risk of postoperative morbidity and unsatisfactory long term outcomes.

Preoperative management of pCC patients includes biliary drainage and modulation of future liver volume, mainly by using portal vein embolization (PVE).

The type of surgical resection is related to tumor extension according to the Bismuth-Corlette classification, and in most cases is a major liver resection associated with caudate resection, extra hepatic bile duct. In addition, an adequate regional lymph-node dissection is required to achieve a curative surgery.

Extended liver resections (of more than 5 liver segments) associated with portal and/or arterial resections has been proposed to increase the radicality of surgery and improve long term results, however results of aggressive surgery are still under evaluation in Western Countries.

Among factors related with long term results, surgical margins and lymph node status are those with higher prognostic value.

An improvement of short- and long-term result of surgery for pCC is desirable, enhanced preoperative patients’ management and improvements of technical aspects of surgical resection are nowadays under evaluation.

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Authors and Affiliations

  1. Department of Surgery, Dentistry, Gynecology and Pediatrics, Division of General and Hepato-Biliary Surgery, University of Verona, Verona, Italy

    Fabio Bagante, Marzia Tripepi, Alfredo Guglielmi, Calogero Iacono & Andrea Ruzzenente

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  1. Fabio Bagante
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  2. Marzia Tripepi
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  3. Alfredo Guglielmi
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  4. Calogero Iacono
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  5. Andrea Ruzzenente
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Corresponding author

Correspondence to Alfredo Guglielmi .

Editor information

Editors and Affiliations

  1. Emeritus Professor, The University of Tokyo, Tokyo, Japan

    Masatoshi Makuuchi

  2. National Center for Global Health and Medicine, The University of Tokyo, Tokyo, Japan

    Norihiro Kokudo

  3. “Dan Setlacec” Center of General Surgery and Liver Transplantation, Fundeni Clinical Institute, Bucharest, Romania

    Irinel Popescu

  4. Emeritus Professor University Paris Cité, Paris, France

    Jacques Belghiti

  5. Department of Surgery, Seoul National University College of Medicine Seoul National University Bundang Hospital, Seoul, Korea (Republic of)

    Ho-Seong Han

  6. Nagahama City Hospital Network, Shiga, Japan

    Kyoichi Takaori

  7. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Dan G. Duda

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Bagante, F., Tripepi, M., Guglielmi, A., Iacono, C., Ruzzenente, A. (2022). Major Hepatic Resection for Peri-hilar Biliary Cancers. In: Makuuchi, M., et al. The IASGO Textbook of Multi-Disciplinary Management of Hepato-Pancreato-Biliary Diseases. Springer, Singapore. https://doi.org/10.1007/978-981-19-0063-1_56

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  • DOI: https://doi.org/10.1007/978-981-19-0063-1_56

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