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Surgical Management of Hilar Cholangiocarcinoma

  • Surgical Oncology (A. Tufaro, Section Editor)
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Abstract

Purpose of Review

To provide a comprehensive review of the preoperative and operative considerations for the surgical management of hilar cholangiocarcinoma.

Recent Findings

The management of hilar cholangiocarcinoma has evolved over the past 20 years, with data from large institutional series emerging, which has influenced decisions regarding the need for preoperative biliary drainage, portal-vein embolization, extent of surgical resection, role of transplantation, and efficacy of adjuvant and palliative therapies.

Summary

Hepatectomy has become the standard of care for resectable hilar cholangiocarcinoma, while transplantation can offer promising results for unresectable patients with localized disease. Perioperative mortality can be minimized through careful preoperative management of the future liver remnant via appropriate use of biliary drainage and portal-vein embolization. Adjuvant therapies prolong survival after resection, while emerging data on endoluminal therapies and radiation provide palliation and improved survival for patients with advanced, unresectable disease.

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  1. Department of Surgery, Section of Surgical Oncology, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA

    Alexander V. Fisher & Sean M. Ronnekleiv-Kelly

  2. H4/710 Clinical Science Center, 600 Highland Ave, Madison, WI, 53792, USA

    Sean M. Ronnekleiv-Kelly

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Fisher, A.V., Ronnekleiv-Kelly, S.M. Surgical Management of Hilar Cholangiocarcinoma. Curr Surg Rep 6, 13 (2018). https://doi.org/10.1007/s40137-018-0210-0

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