Abstract:

Objective

To evaluate the surgical approaches and their clinical effects for hilar cholangiocarcinoma.

Methods

Fifty-eight patients underwent the surgical procedures of skeletonzation for hepatic artery and portal vein, high level resection of hepatic ducts and concomitant hepatic lobectomy or segmentectomy. Hepaticojejunostomy was performed after hepatic duct forming, with others undergoing hepatojejunostomy.

Results

Histological grade was classified as high differentiation in 21 patients, moderate in 18, and low in 19. Fifty-two patients (89.7%) were verified R0 curative resection, and surgical margin was positive in 6 patients (10.3%). 8 cases of bile leakage were observed. Regurgitation cholangitis occurred in 3 patients. One patient undergoing combined left hemihepatectomy died postoperatively from hepatic failure. Fifty-three patients had been followed up for 1 to 10 years. The 1-, 3-, 5-year survival rate was 75.5% (40/53), 45.3% (24/53), and 26.4% (14/53), respectively.

Conclusions

Skeletonzation resection for hilar cholangiocarcinoma may improve surgical curative efficacy. High level resection of hepatic ducts and concomitant lobectomy or segmentectomy of liver may improve resection rate and therapeutic effect.

Key words: Cholangiocarcinoma, Skeletonization resection, High level resection of hepatic ducts, Hepaticojejunostomy, Hepatojejunostomy