Hepatobiliary surgery and nutrition · 2016
Combined liver and extrahepatic bile duct resection for biliary invasion of colorectal metastasis: a case-cohort analysis and systematic review.
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Wiggers Jimme K, Te Riele Wouter W, van Dongen Tristan H, Verheij Joanne, Busch Olivier R C, van Gulik Thomas M
Аннотация
BACKGROUND: Colorectal liver metastases (CRLMs) with biliary invasion can be treated with a combined liver and extrahepatic bile duct resection. The aim of this study was to analyze outcomes of this procedure in a case-cohort analysis and systematic review.
METHODS: Consecutive patients who underwent a major liver resection for CRLM between 2003 and 2013 were selected from a single center prospective database, comparing patients with and without biliary invasion. A specific and a general search strategy were used to identify relevant articles in the systematic review.
RESULTS: Ten patients (13.2%) underwent combined liver and extrahepatic bile duct resection for CLRM with biliary invasion, among 76 patients included. An R0 resection was achieved in five of ten patients (50%); one of ten patients died postoperatively. Median overall survival was 19 months among patients with biliary invasion, versus 106 months among patients without biliary invasion (P=0.12). The systematic review yielded a large variability in 5-year survival after resection of CLRM with biliary invasion, ranging between 33-80%.
CONCLUSIONS: Surgical resection of CLRM with central biliary invasion is feasible, but survival in these patients tends to be lower due to a high rate of non-radical resections.
METHODS: Consecutive patients who underwent a major liver resection for CRLM between 2003 and 2013 were selected from a single center prospective database, comparing patients with and without biliary invasion. A specific and a general search strategy were used to identify relevant articles in the systematic review.
RESULTS: Ten patients (13.2%) underwent combined liver and extrahepatic bile duct resection for CLRM with biliary invasion, among 76 patients included. An R0 resection was achieved in five of ten patients (50%); one of ten patients died postoperatively. Median overall survival was 19 months among patients with biliary invasion, versus 106 months among patients without biliary invasion (P=0.12). The systematic review yielded a large variability in 5-year survival after resection of CLRM with biliary invasion, ranging between 33-80%.
CONCLUSIONS: Surgical resection of CLRM with central biliary invasion is feasible, but survival in these patients tends to be lower due to a high rate of non-radical resections.