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Surgical Resection of Hilar Cholangiocarcinoma: Analysis of Survival and Postoperative Complications

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Abstract

Background

Surgery is the only potentially curative treatment for hilar bile duct cancer. This study sought to evaluate the efficacy and feasibility of surgical management of hilar bile duct carcinoma, including radical hepatectomy, at a single institution.

Methods

We performed a retrospective review of 49 consecutive patients who underwent surgery at our hospital between 1990 and 2003.

Results

Altogether, 44 of 49 patients underwent radical hepatectomy combined with caudate lobectomy and lymphadenectomy. One and four patients underwent partial hepatectomy or bile duct resection, respectively. No patients underwent preoperative portal vein embolization. The 5-year survival rate was 39.7%, with a median survival time of 3.75 years. The postoperative morbidity and mortality rates were 46.8% and 2.0%, respectively. Cox’s proportional hazard model revealed that lymph node status and the residual tumor factor were independent prognostic factors. Multivariate analysis revealed that preoperative hyperbilirubinemia, postoperative complications, and extended surgical procedures were independently associated with postoperative hyperbilirubinemia. After potentially curative resection, 39.4% of patients suffered from disease recurrence. In 60% of the total cases, the sites of recurrence were distant metastases.

Conclusion

Surgery, including radical hepatectomy combined with caudate lobectomy and lymph node dissection, is a feasible, effective treatment for hilar bile duct cancer.

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Authors and Affiliations

  1. Department of Surgery, Kyoto University Hospital, Kyoto, 606-8507, Japan

    Suguru Hasegawa, Iwao Ikai, Hideaki Fujii, Etsuro Hatano & Yasuyuki Shimahara

  2. Department of Surgery, Kyoto University Hospital, 54 Shogoin Kawahara-cho, Sakyo, Kyoto, 606-8507, Japan

    Suguru Hasegawa

Authors
  1. Suguru Hasegawa
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  2. Iwao Ikai
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  3. Hideaki Fujii
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  4. Etsuro Hatano
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  5. Yasuyuki Shimahara
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Correspondence to Suguru Hasegawa.

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Hasegawa, S., Ikai, I., Fujii, H. et al. Surgical Resection of Hilar Cholangiocarcinoma: Analysis of Survival and Postoperative Complications. World J Surg 31, 1258–1265 (2007). https://doi.org/10.1007/s00268-007-9001-y

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