American journal of surgery · 2004
In-continuity hepatic resection for advanced hilar cholangiocarcinoma.
Сравнительное исследованиеСтатьяНазвание и аннотация: Перевод пока не подготовлен
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Zervos Emmanuel E, Pearson Heidi, Durkin Alan J, Thometz Donald, Rosemurgy Percy, Kelley Scott, Rosemurgy Alexander S
Аннотация
BACKGROUND: The purpose of this study was to examine outcomes of patients undergoing concomitant hepatectomy and bile duct excision for advanced Klatskin tumors.
METHODS: Thirty-one patients, 16 men and 15 women, with an average age of 64 years, underwent concomitant biliary and hepatic resections for Klatskin tumors. Outcomes, including complications and survival, are reported.
RESULTS: Fifteen patients had postoperative courses free of complications. Sixteen patients experienced a total of 50 complications; 13 patients experienced 1 or more major complications (including hemorrhage [n = 1], pneumonia [n = 5], intra-abdominal abscess [n = 8], hepatic failure [n = 3], and myocardial infarction [n = 2]). Five patients died perioperatively, 1 from adult respiratory distress syndrome and 4 from multisystem organ failure precipitated by hepatic failure. One-, 3-, and 5-year survival after resection was 69%, 33%, and 26%, respectively. American Joint Committee on Cancer stage and margin status did not impact long-term survival after resection.
CONCLUSIONS: Concomitant hepatic and biliary resections for Klatskin tumors carry relatively high risk but offer hope for long-term survival. This study supports in-continuity hepatectomy and extrahepatic biliary resection for advanced Klatskin tumors even when microscopically negative margins cannot be obtained.
METHODS: Thirty-one patients, 16 men and 15 women, with an average age of 64 years, underwent concomitant biliary and hepatic resections for Klatskin tumors. Outcomes, including complications and survival, are reported.
RESULTS: Fifteen patients had postoperative courses free of complications. Sixteen patients experienced a total of 50 complications; 13 patients experienced 1 or more major complications (including hemorrhage [n = 1], pneumonia [n = 5], intra-abdominal abscess [n = 8], hepatic failure [n = 3], and myocardial infarction [n = 2]). Five patients died perioperatively, 1 from adult respiratory distress syndrome and 4 from multisystem organ failure precipitated by hepatic failure. One-, 3-, and 5-year survival after resection was 69%, 33%, and 26%, respectively. American Joint Committee on Cancer stage and margin status did not impact long-term survival after resection.
CONCLUSIONS: Concomitant hepatic and biliary resections for Klatskin tumors carry relatively high risk but offer hope for long-term survival. This study supports in-continuity hepatectomy and extrahepatic biliary resection for advanced Klatskin tumors even when microscopically negative margins cannot be obtained.
Предметные рубрики MeSH
AdultAge DistributionAgedAged, 80 and overBile Duct NeoplasmsCholangiocarcinomaCombined Modality TherapyConfidence IntervalsDisease ProgressionFemaleFollow-Up StudiesHepatectomyHepatic Duct, CommonHumansKlatskin TumorMaleMiddle AgedProbabilityProspective StudiesReference ValuesRisk AssessmentSex DistributionSurvival AnalysisTreatment Outcome