DOI: https://doi.org/10.22141/1997-2938.1.36.2018.134391

Aggressive surgical treatment of the perihilar cholangiocarcinoma with portal vein invasion

O.G. Kotenko, A.O. Popov, A.V. Grinenko, A.V. Gusev, M.S. Grigorjan, D.A. Fedorov, A.A. Korshak, O.N. Ostapyshen, A.A. Minich, A.I. Zhylenko, K.A. Yuzvyk

Abstract


Background. Perihilar cholangiocarcinoma is a rare type of malignant neoplasms and accounts for 3–7 cases per 100,000 population. Surgery is the only radical method of treatment which improves long-term survival results. The cases with tumor invasion of the portal vein are of particular complexity. The purpose of this research was to study the results of surgical treatment in patients with perihilar cholangiocarcinoma and portal vein invasion. Materials and methods. From 2003 to 2017, at the department of transplantation and surgery of the liver, extensive and advanced liver resections were performed in 141 patients with perihilar cholangiocarcinoma. Results. To establish the nature of the biliary tree lesions, Bismuth-Corlette anatomical classification of perihilar cholangiocarcinoma was used. In 61 of 141 (46.6 %) cases, a portal vein resection was performed with subsequent reconstruction. One-, three- and five-year survival rate in the group of patients with portal vein resection was 85.6, 56 and 42 %, respectively. Conclusions. Aggressive surgical treatment for perihilar cholangiocarcinoma provides maximum radicality, allows increasing resectability in case of tumor invasion of the portal vein with acceptable mortality and long-term survival rate.


Keywords


perihilar cholangiocarcinoma; portal vein; invasion; surgical treatment

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