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One hundred seven consecutive surgical resections for hilar cholangiocarcinoma of Bismuth types II, III, IV between 2001 and 2008

  • Topics
  • A new era of surgical treatment of hilar cholangiocarcinoma: comparison of leading Eastern and Western centers
  • Published:
Journal of Hepato-Biliary-Pancreatic Sciences

Abstract

Many authors at high-volume centers all over the world have reported improved outcomes of hilar cholangiocarcinoma by several aggressive surgical approaches such as extended hepatic resection, combined vascular resection, and hepatopancreaticoduodenectomy in recent years. There has been great progress in the surgical treatment of hilar cholangiocarcinoma with these previous efforts by aggressive hepatobiliary surgeons. In particular, surgical techniques, diagnostic modalities, and perioperative management have been remarkably improved as compared with before. Herein we report the surgical outcome for both hilar cholangiocarcinoma of Bismuth types II, III, and IV and intrahepatic cholangiocarcinoma involving the hepatic duct confluence during the recent 8-year period between 2001 and 2008 at our institution, the Department of General Surgery at Chiba University. From our recent experienced results, it can be concluded that the surgical strategy for hilar cholangiocarcinoma has been improved remarkably, and major surgical hepatectomy can be done with relative safety, and these aggressive surgical approaches, including combined vascular resection, may be warranted for the surgical treatment of hilar cholangiocarcinoma. However, the adoption of new innovative therapeutic approaches might be required for further improvement of surgical outcome of hilar cholangiocarcinoma.

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References

  1. Nagino M, Kamiya J, Arai T, Nishio H, Ebata T, Nimura U. “Anatomic” right hepatic trisectionectomy (extended right hepatectomy) with caudate lobectomy for hilar cholangiocarcinoma. Ann Surg. 2006;243:28–32.

    Article  PubMed  Google Scholar 

  2. Neuhaus P, Jonas S, Settmacher U, Thelen A, Benckert C, Lopez-Hänninen E, et al. Surgical management of proximal bile duct cancer: extended right lobe resection increases resectability and radicality. Langenbecks Arch Surg. 2003;388:194–200.

    Article  PubMed  Google Scholar 

  3. Hemming WA, Reed IA, Fujita S, Foley PD, Howard JR. Surgical management of hilar cholangiocarcinoma. Ann Surg. 2005;241:693–702.

    Article  PubMed  Google Scholar 

  4. Kondo S, Hirano S, Ambo Y, Tanaka E, Okushiba S, Morikawa T, et al. Forty consecutive resections of hilar cholangiocarcinoma with no postoperative mortality and no positive ductal margins. Ann Surg. 2004;240:95–101.

    Article  PubMed  Google Scholar 

  5. Miyazaki M, Kato A, Ito H, Kimura F, Shimizu H, Ohtsuka M, et al. Combined vascular resection in operative resection for hilar cholangiocarcinoma: Does it work or not? Surgery. 2006;141:581–8.

    Article  Google Scholar 

  6. Nagorney MD, Kendrick KM. Hepatic resection in the treatment of hilar cholangiocarcinoma. Adv Surg. 2006;40:159–71.

    Article  PubMed  Google Scholar 

  7. Bismuth H, Nakache R, Diamond T. Management strategies in resection for hilar cholangiocarcinoma. Ann Surg. 1992;215:31–8.

    Article  CAS  PubMed  Google Scholar 

  8. Miyazaki M, Ito H, Nakagawa K, Ambiru S, Shimizu H, Okaya T, et al. Parenchyma-preserving hepatectomy in the surgical treatment of hilar cholangiocarcinoma. J Am Coll Surg. 1999;189:575–83.

    Article  CAS  PubMed  Google Scholar 

  9. Miyazaki M, Kimura F, Shimizu H, Yoshidome H, Otsuka M, Kato A, et al. Extensive hilar bile duct resection using a transhepatic approach for patients with hepatic hilar bile duct diseases. Am J Surg. 2008;196:125–9.

    Article  PubMed  Google Scholar 

  10. Miyazaki M, Ito H, Kaiho T, Ambiru S, Togawa A, Sasada K, et al. Portal vein reconstruction at the hepatic hilus using a left renal vein graft. J Am Coll Surg. 1995;180:497–8.

    CAS  PubMed  Google Scholar 

  11. Kondo S, Takada T, Miyazaki M, Miyazawa S, Tsukuda K, Nagino M, et al. Guidelines for the management of biliary tract and ampullary carcinomas: surgical treatment. J Hepatobiliary Pancreat Surg. 2008;15:41–54.

    Article  PubMed  Google Scholar 

  12. Tsao JI, Nimura Y, Kamiya J, Hayakawa N, Kondo S, Nagino M, et al. Management of hilar cholangiocarcinoma: comparison of an American and a Japanese experience. Ann Surg. 2000;232:166–74.

    Article  CAS  PubMed  Google Scholar 

  13. Klempanuer J, Ridder JG, Werner M, Weimann A, Pichlmayr R. What constitutes long term survival after surgery for hilar cholangiocarcinoma? Cancer. 1997;79:26–34.

    Article  Google Scholar 

  14. Sano T, Shimada K, Sakamoto Y, Ojima H, Esaki M, Kosuge T. Prognosis of perihilar cholangiocarcinoma: hilar bile duct cancer versus intrahepatic cholangiocarcinoma involving the hepatic hilus. Ann Surg Oncol. 2008;15:590–9.

    Article  PubMed  Google Scholar 

  15. Jarnagin RW, Bowne W, Klimstra SD, Roggin K, Cymes K, Fong Y, et al. Papillary phenotype confers improved survival after resection of hilar cholangiocarcinoma. Ann Surg. 2550;241:703–14.

    Article  Google Scholar 

  16. Hirano S, Tanaka E, Shichinohe T, Suzuki O, Hazama K, Kitagami H, et al. Treatment strategy for hilar cholangiocarcinoma, with special reference to the limits of ductal resection in right-sided hepatectomies. J Hepatobilary Pancreat Surg. 2007;14:429–33.

    Article  Google Scholar 

  17. Shimizu H, Sawada S, Kimura F, Yoshidome H, Ohtsuka M, Kato A, et al. Clinical significance of biliary vascular anatomy of the right liver for hilar cholangiocarcinoma applied to left hemihepatectomy. Ann Surg. 2009;249:435–9.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuou-ku, Chiba, 260-0856, Japan

    Masaru Miyazaki, Fumio Kimura, Hiroaki Shimizu, Hiroyuki Yoshidome, Masayuki Otuka, Atushi Kato, Hideyuki Yoshitomi, Katsunori Furukawa, Dan Takeuchi, Tsukasa Takayashiki, Kousuke Suda & Shigetugu Takano

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  1. Masaru Miyazaki
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  2. Fumio Kimura
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  3. Hiroaki Shimizu
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  4. Hiroyuki Yoshidome
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  5. Masayuki Otuka
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  6. Atushi Kato
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  7. Hideyuki Yoshitomi
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  8. Katsunori Furukawa
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  9. Dan Takeuchi
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  10. Tsukasa Takayashiki
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  11. Kousuke Suda
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  12. Shigetugu Takano
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Corresponding author

Correspondence to Masaru Miyazaki.

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Miyazaki, M., Kimura, F., Shimizu, H. et al. One hundred seven consecutive surgical resections for hilar cholangiocarcinoma of Bismuth types II, III, IV between 2001 and 2008. J Hepatobiliary Pancreat Sci 17, 470–475 (2010). https://doi.org/10.1007/s00534-009-0207-2

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  • DOI: https://doi.org/10.1007/s00534-009-0207-2

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