Parenchyma-Preserving Hepatectomy in Perihilar Cholangiocarcinoma: A Chance for Critical Patients?

Overview

Journal Visc Med

Date 2024 Apr 8

PMID 38584859

Authors

Tobias S Broring

Kim C Wagner

Thomas von Hahn

Karl J Oldhafer

Affiliations

Soon will be listed here.

Abstract

Introduction: Surgery for perihilar cholangiocarcinoma (pCCA) is associated with high rates of postoperative morbidity and mortality. Extended liver resection (EXT) increases R0 resection rate and survival; however, patients with high perioperative risk are not suitable for extended resection. This study aimed to compare overall survival and surgical morbidity in patients with extended liver resection and parenchyma-preserving hepatectomy (PPH).

Methods: Between January 2010 and November 2020, 113 consecutive patients with pCCA underwent surgery at our institution. Eighty-two patients were resected in curative intent. Sixty-four patients received extended liver resection, and 18 patients PPH. Outcomes of resections were evaluated.

Results: There was no significant difference in overall survival in patients with PPH compared to extended liver resection (log-rank = 0.286). Patients with PPH experienced lower rates of postoperative morbidity and mortality. There was no case of in-house mortality in PPH-resected patients compared to 10 cases (16%) in patients that received EXT ( = 0.073).

Conclusion: PPH shows similar overall survival with lower rates of postoperative morbidity and mortality. Our findings support the role of a PPH, in selected patients with pCCA, that are not suitable for extended resection due to increased perioperative risk.

Citing Articles

Influence of Perineural (Pn), Lymphangio (L) and Vascular (V) Invasion on Survival after Resection of Perihilar Cholangiocarcinoma.

Margies R, Groger L, Straub B, Bartsch F, Lang H Cancers (Basel). 2024; 16(20).

PMID: 39456557 PMC: 11506491. DOI: 10.3390/cancers16203463.

Pattern and extent of intrahepatic infiltration of perihilar cholangiocarcinoma - a case-control study based on liver panoramic digital pathology.

Jin S, Jiang N, Zhao J, Xiao Y, Wang S, Xiang C Int J Surg. 2024; 111(1):31-39.

PMID: 39166939 PMC: 11745584. DOI: 10.1097/JS9.0000000000002040.

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