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Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Achievement of negative margins is the goal of curative intent surgery for hilar cholangiocarcinoma. This study analyzed factors affecting survival in hilar cholangiocarcinoma patients and compared short- and long-term outcomes of left- and right-sided resections.

Methods

One hundred and five patients out of 124 diagnosed with Klatskin tumors underwent major liver resection. Sixty-one patients underwent right-sided resections (right group), whereas 44 underwent left-sided resections (left group). Perioperative morbidity, perioperative mortality, and overall and disease-free survival were compared between the groups.

Results

Morbidity and mortality were higher in the right group (59 and 8.2 %, respectively) than in the left group (38.6 and 2.3 %, respectively) (p < 0.005). The most frequent cause of death was liver failure. The R0 rate was 75.4 % in the right and 61.4 % in the left group. The 5-year survival rate was 42.8 % in the right and 35.3 % in the left group (p < 0.05). Patients in the left group more frequently developed local recurrence (87 vs. 69 % in the right group).

Conclusion

Lesion side impacts outcome: right resections still cause significant morbidity related to extensive parenchymal sacrifice but are associated with better long-term survival because right hepatic pedicle resection enables better radicality compared with left resections.

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Conflict of Interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Hepatobiliary Surgery Division, Ospedale San Raffaele, Via Olgettina 60, Milan, Italy

    Francesca Ratti, Federica Cipriani, Guglielmo Piozzi, Marco Catena, Michele Paganelli & Luca Aldrighetti

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  1. Francesca Ratti
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  2. Federica Cipriani
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  3. Guglielmo Piozzi
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  4. Marco Catena
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  5. Michele Paganelli
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  6. Luca Aldrighetti
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Correspondence to Francesca Ratti.

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Ratti, F., Cipriani, F., Piozzi, G. et al. Comparative Analysis of Left- Versus Right-sided Resection in Klatskin Tumor Surgery: can Lesion Side be Considered a Prognostic Factor?. J Gastrointest Surg 19, 1324–1333 (2015). https://doi.org/10.1007/s11605-015-2840-1

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  • DOI: https://doi.org/10.1007/s11605-015-2840-1

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