Volume 37, Issue 4 1 pp. 829-837
Article

Liver Resection for Bismuth Type I and Type II Hilar Cholangiocarcinoma

Jin Hong Lim

Jin Hong Lim

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

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Gi Hong Choi

Corresponding Author

Gi Hong Choi

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

Tel.: +82-2-2228-2100, Fax: +82-2-313-8289, [email protected]Search for more papers by this author
Sung Hoon Choi

Sung Hoon Choi

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

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Kyung Sik Kim

Kyung Sik Kim

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

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Jin Sub Choi

Jin Sub Choi

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

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Woo Jung Lee

Woo Jung Lee

Department of Surgery, Yonsei University College of Medicine, 134, Sinchon-dong, Seodaemum-gu, 120-75 Seoul, Korea

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First published: 25 January 2013
Citations: 43

Abstract

Background

In patients with Bismuth type I and II hilar cholangiocarcinoma (HCCA), bile duct resection alone has been the conventional approach. However, many authors have reported that concomitant liver resection improved surgical outcomes.

Methods

Between January 2000 and January 2012, 52 patients underwent surgical resection for a Bismuth type I and II HCCA (type I: n = 22; type II: n = 30). Patients were classified into two groups: concomitant liver resection (n = 26) and bile duct resection alone (n = 26).

Results

Bile duct resection alone was performed in 26 patients. Concomitant liver resection was performed in 26 patients (right side hepatectomy [n = 13]; left-side hepatectomy [n = 6]; volume-preserving liver resection [n = 7]). All liver resections included a caudate lobectomy. Patient and tumor characteristics did not differ between the two groups. Although concomitant liver resection required longer operating time (P < 0.001), it had a similar postoperative complication rate (P = 0.764), high curability (P = 0.010), and low local recurrence rate (P = 0.006). Concomitant liver resection showed better overall survival (P = 0.047).

Conclusions

Concomitant liver resection should be considered in patients with Bismuth type I and II HCCA.

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