Ex Situ Ex Vivo Resection and Autotransplantation

  • A. K. K. Chui


Cholangiocarcinoma represents a difficult cancer with poor prognosis. It is not a common disease, and may occur anywhere along the intrahepatic or extrahepatic biliary tree. Cholangiocarcinoma usually presents with painless jaundice, and this diagnosis should be considered in every case of obstructive jaundice. These bile duct cancers are best classified according to the anatomical location into three board groups: (a) intrahepatic, (b) hilar or perihilar, and (c) distal [1]. Intrahepatic cholangiocarcinomas occur with the lowest frequency and are usually managed with liver resection, as are other resectable liver tumors. Distal type cholangiocarcinomas are the second most common type accounting for about 25 %. Depending on whether the extrahepatic bile duct is involved above or below the upper border of duodenum, treatment is usually with extrahepatic bile duct resection with or without pancreatoduodenectomy. Tumor that involves the confluence of the right and left hepatic ducts (hilar cholangiocarcinoma) is the most common. It accounts for about 60 % of all cholangiocarcinoma cases [2, 3]. Bismuth and Corlette further classified the hilar cholangiocarcinomas into four subtypes [4]. Regardless of the biliary locations or the subtypes of cholangiocarcinomas, surgical resection of the tumor, whenever possible, is the preferred treatment and is the only effective treatment modality that is capable of offering a chance of cure. However, for many patients with metastatic or peritoneal spread, surgical tumor clearance is not possible and is not recommended.


Portal Vein Liver Transplantation Liver Resection Inferior Vena Cava Hepatic Vein 
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Copyright information

© Springer Science+Business Media Dordrecht and People's Medical Publishing House 2013

Authors and Affiliations

  1. 1.Private PracticeCentralHong Kong

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