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cholangiocarcinoma and hilar

Yu A Kovalenko, V A Vishnevsky, A V Chzhao, Yu O Zharikov
AIM: To develop new criteria of radical surgery for hilar cholangiocarcinoma (HCC). MATERIAL AND METHODS: There were 165 HCC patients who underwent surgery in 1986-2016 at the Vishnevsky Institute of Surgery. TNM stage distribution: stage I - 4 (2.4%), II - 45 (27.3%) (29 of them are referred to the 1st period of work), IIIA - 23 (13.9%), IIIB - 41 (24.8%), IVA - 35 (21.2%), IVB - 17 (10.3%). 80 (48%) patients underwent hemihepatectomy, 17 (10%) - advanced hemihepatectomy, 16 (10%) - minor liver resection with common bile duct repair, 52 (32%) - common bile duct repair resection...
2018: Khirurgiia
Meisheng Li, Qinghan Li, Qiucheng Lei, Jianyuan Hu, Fengjie Wang, Huanwei Chen, Zuojun Zhen
RATIONALE: Ectopic variceal bleeding due to hepaticojejunostomy (HJ) is unusual and difficult to manage. Reports on the use of side-to-side splenorenal shunt for severe bleeding from varices at HJ anastomosis are lacking. PATIENT CONCERNS: A 43-year-old man was admitted to our hospital with repeated episodes of hematemesis. He has a history of right hemihepatectomy with HJ reconstruction to the left hepatic duct for hilar cholangiocarcinoma. Two years after surgery, he presented with repeated episodes of hematemesis and underwent blood transfusion...
August 2018: Medicine (Baltimore)
Hai-Jie Hu, Yan-Wen Jin, Rong-Xing Zhou, Wen-Jie Ma, Qin Yang, Jun-Ke Wang, Fei Liu, Nan-Sheng Cheng, Fu-Yu Li
BACKGROUND: We aimed to examine whether inflammation-based prognostic scores could predict tumor resectability in a cohort of hilar cholangiocarcinoma patients with preoperative hyperbilirubinemia. We also sought to investigate the prognostic factors associated with overall survival in the subgroup of patients with an R0 resection. METHODS: A total of 173 patients with potentially resectable hilar cholangiocarcinoma, as judged by radiological examinations, were included...
August 3, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Emily K Martin, Neal Bhutiani, Michael E Egger, Prejesh Philips, Charles R Scoggins, Kelly M McMasters, Lawrence R Kelly, Gary C Vitale, Robert C G Martin
BACKGROUND: Irreversible electroporation (IRE) has successfully been used for palliation of pancreatic and liver cancers due to its ability to ablate tumors without destroying nearby vital structures. To date, it has not been evaluated in patients with advanced hilar cholangiocarcinoma (AHC). This study presents a single-institution experience with IRE for management of obstructive jaundice in AHC. METHODS: A single-institution database was queried for patients undergoing IRE for AHC after PTBD placement for relief of obstructive jaundice from 2010 to 2017 and compared to a control group treated with standard of care only (No IRE)...
July 26, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Zhaolun Cai, Yuan Yin, Zhaohui Cai, Zhou Zhao, Chaoyong Shen, Xiaonan Yin, Jian Wang, Zhixin Chen, Dan Cao, Bo Zhang
BACKGROUND: Either liver transplantation or surgical resection is available for selected patients with hilar cholangiocarcinoma. However, the comparative effectiveness between liver transplantation and liver resection remains unknown. The aim of our study is to evaluate the relative effectiveness between liver transplantation and surgical resection in patients with hilar cholangiocarcinoma. METHODS: We will systematically search for eligible studies in PubMed, Embase, and the Cochrane library...
July 2018: Medicine (Baltimore)
Georgi Atanasov, Corinna Dietel, Linda Feldbrügge, Christian Benzing, Felix Krenzien, Andreas Brandl, Shadi Katou, Katrin Schierle, Simon C Robson, Katrin Splith, Georg Wiltberger, Anja Reutzel-Selke, Sven Jonas, Andreas Pascher, Marcus Bahra, Johann Pratschke, Moritz Schmelzle
Background: Tumour angiogenesis is modulated on both an epigenetic and protein level and has potential implications for immune cell responses. However, the importance of related angiogenic biomarkers in cholangiocarcinoma (CCA) is unknown. This study assessed human CCA samples for the expression of angiogenesis-associated microRNAs, angiopoietins (Angs) and monocytes expressing the Ang-receptor, TIE2, with regards to prognostic significance after liver resection. Methods: Angiogenic miRNAs were analysed in frozen samples of intrahepatic CCA (iCC; n = 43) and hilar CCA (HC; n = 45)...
July 6, 2018: Oncotarget
Qun Zhou, Yue Guan, Liang Mao, Yong Zhu, Jun Chen, Jiong Shi, Min Tang, Yudong Qiu, Bin Zhu, Jian He
BACKGROUND: To compare the diagnostic performance of CT criteria and to establish a new model in evaluating portal venous invasion by hilar cholangiocarcinoma. METHODS: CT images of 67 patients with hilar cholangiocarcinoma were retrospectively reviewed. Modified Loyer's, Lu's and Li's standard introduced from pancreatic cancer were used to evaluate portal venous invasion with the reference of intraoperative findings and/or postoperative pathological diagnosis. A new model was constructed with modified Lu's standard and contact length between portal vein and tumor...
July 17, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Xinjian Wan, Sumin Chen, Qiuyan Zhao, Tian Li, Shengzheng Luo, Xiaobo Cai, Yingchun Ren, Lanting Yu, Baiwen Li
Background/Aims: Although endoscopic metal biliary endoprosthesis (EMBE) is widely accepted as the most suitable drainage method for patients with unresectable malignant obstruction, uncontrolled post-procedural cholangitis is still a problem. We aimed to validate a new treatment modality to prevent post-ERCP cholangitis in patients with unresectable cholangiocarcinoma. Patients and Methods: A total of 378 patients who were diagnosed with unresectable malignant biliary obstruction and underwent EMBE or temporary endoscopic nasobiliary drainage (ENBD) following EMBE placement, from January 2010 to July 2016, were enrolled in this retrospective study...
July 9, 2018: Saudi Journal of Gastroenterology: Official Journal of the Saudi Gastroenterology Association
Jun Zhang, Qi-Lu Qiao, Xiao-Chao Guo, Jian-Xun Zhao
OBJECTIVE: This study aims to investigate the role of three-dimensional visualization technique in the diagnosis and treatment of progressive hilar cholangiocarcinoma. METHODS: From January 2014 to February 2017, a three-dimensional visualization model was set up in 23 patients with progressive hilar cholangiocarcinoma. The distributions and variations of the hepatic portal ducts were observed. The tumors were classified based on Bismuth classification. The simulation operation was performed and the operation plan was established...
2018: American Journal of Translational Research
Ke Xiao, Zhengxiao Ouyang, Hui-Huan Tang
The aim of the present study was to investigate whether the proliferation and metastasis of hilar cholangiocarcinoma cells can be suppressed and whether apoptosis can be induced by small interfering RNA (siRNA) repression of vascular endothelial growth factor (VEGF). siRNA sequences targeting the VEGF gene were designed and the human hilar cholangiocarcinoma QBC939, HCCC-9810 and RBE cell lines were transfected with VEGF-siRNA plasmids for 48 h. Reverse transcription-quantitative polymerase chain reaction and western blotting measured the levels of VEGF-A, VEGF-C and matrix metalloproteinase 2 (MMP2) mRNA expression and protein content...
August 2018: Oncology Letters
Ryohei Ono, Hiroyuki Kashiwagi, Jun Kawachi, Naoko Isogai, Katsunori Miyake, Takaaki Murata, Rai Shimoyama, Ryuta Fukai, Hidemitsu Ogino, Nobuaki Shinozaki
INTRODUCTION: Liver gas gangrene is rare and has a low prognosis. This case, reports a successful treatment of hepatic gas gangrene using an open drainage technique, followed by antibiotics and hyperbaric oxygen therapy (HBO). PRESENTATION OF THE CASE: An 82-year-old male with a history of left hepatectomy and bile duct resection for hilar cholangiocarcinoma presented with chilling, lethargy and dyspnea. He had a history of diabetes mellitus, hypertension, atrial fibrillation, and angina pectoris...
June 30, 2018: International Journal of Surgery Case Reports
Michael E Lidsky, William R Jarnagin
Hilar cholangiocarcinoma, which represents approximately 60% of biliary tract malignancies, is increasing in incidence and presents an ongoing challenge for patients and hepatobiliary surgeons. Although the majority of patients present with advanced disease, the remaining minority of patients are best treated with surgical resection or transplant. Transplant is typically reserved for locally unresectable tumors often in the setting of underlying hepatic dysfunction and will not be discussed herein. This review, therefore, focuses on oncological resection and the strategies implemented for the treatment of hilar cholangiocarcinoma at a quaternary referral center, including preoperative considerations such as patient selection and optimization of the future liver remnant, nuances to the operative approach for these tumors such as resection under low central venous pressure and management of the bile duct, as well as postoperative management...
July 2018: Annals of gastroenterological surgery
N T E Bird, A McKenna, J Dodd, G Poston, R Jones, H Malik
BACKGROUND: Hilar cholangiocarcinoma is staged using the AJCC staging system. Numerous other prognostically important histopathological and demographic characteristics have been reported. The objective of this meta-analysis was to assess statistically the effect of postresectional tumour characteristics on overall survival of patients undergoing attempted radical curative resection for hilar cholangiocarcinoma. METHODS: Relevant studies were identified by searching the Ovid MEDLINE and PubMed databases...
July 12, 2018: British Journal of Surgery
Daryl Ramai, Karl Zakhia, Denzil Etienne, Armand Asarian, Madhavi Reddy
The widespread use of liver biopsies underscores its utility and significance within the field of medicine. Dr. Gerald Klatskin's pioneering work on liver biopsy techniques, as well as his study of liver histopathology, paved the way for its diagnostic and therapeutic applications around the world. His attention to detail as well as meticulous account of hilar cholangiocarcinoma has had a lasting impact on the medical community. Eponymously, the tumor was named after him-Klatskin's tumor. Klatskin was also well known and respected for his commitment and devotion to his fellows who themselves went on to hold prestigious academic positions and make significant contributions of their own...
January 1, 2018: Journal of Medical Biography
Rajesh Ramanathan, Jeffrey Borrebach, Samer Tohme, Allan Tsung
BACKGROUND: Preoperative biliary drainage (PBD) prior to liver resection for hilar and intrahepatic cholangiocarcinoma (CCA) is common. While PBD for those with distal obstructions has been studied extensively and is associated with increased infectious complications, the impact of PBD among patients undergoing hepatectomy for non-disseminated proximal CCA has yet to be clearly elucidated. METHODS: Patients undergoing liver resection between 2014 and 2016 for non-disseminated hilar and intrahepatic CCA were analyzed using the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database...
July 6, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Xuling Li, Ying Zhang, Yongyang Zhang
BACKGROUND: As the most common cholangiocarcinoma, hilar cholangiocarcinoma (HCCA) is a challenge in hepatobiliary surgery and causes a very poor prognosis. This study was designed to explore whether 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) may be a suitable method for preoperative diagnosis and evaluation of Chinese older patients with hilar cholangiocarcinoma. METHODS: This study enrolled 53 patients (≥ 65 years) with HCCA...
July 6, 2018: BMC Geriatrics
Jun Li, Moustafa Mohamed, Lutz Fischer, Björn Nashan
BACKGROUND: Segment 5 (S5) sparing liver resection for cases that require an anatomic left trisectionectomy has not been reported yet. The authors intended to verify the outcome of S5-sparing extended left hepatectomy (ELH) in respect to venous outflow. METHODS: All adult patients who underwent S5-sparing ELH between 2012 and 2017 in authors' institute have been enrolled in this study. S5-sparring ELH was defined as resection of S2, S3, S4, and S8 with or without S1...
June 28, 2018: Langenbeck's Archives of Surgery
Hayato Nakagawa, Yuki Hayata, Tomoharu Yamada, Satoshi Kawamura, Nobumi Suzuki, Kazuhiko Koike
The identification of the cellular origin of cancer is important for our understanding of the mechanisms regulating carcinogenesis, thus the cellular origin of cholangiocarcinoma (CCA) is a current topic of interest. Although CCA has been considered to originate from biliary epithelial cells, recent studies have suggested that multiple cell types can develop into CCA. With regard to the hilar and extrahepatic bile ducts, peribiliary glands (PBGs), a potential stem cell niche of biliary epithelial cells, have attracted attention as the cellular origin of biliary tract cancer...
June 12, 2018: International Journal of Molecular Sciences
Leonard M Quinn, Declan F J Dunne, Robert P Jones, Graeme J Poston, Hassan Z Malik, Stephen W Fenwick
Surgical resection remains the only proven curative treatment for peri-hilar cholangiocarcinoma. Despite recent advances in liver surgery techniques and perioperative care, resection for peri-hilar cholangiocarcinoma remains associated with significant morbidity and mortality. Considerable variation in the perioperative management of these patients exists. Optimal perioperative management has the potential to deliver improved outcomes. This article seeks to summarize the evidence underpinning best practice in the perioperative care of patients undergoing resection of peri-hilar cholangiocarcinoma...
2018: European Surgery: ACA: Acta Chirurgica Austriaca
Eric Vibert, Emmanuel Boleslawski
No abstract text is available yet for this article.
June 1, 2018: Annals of Surgery
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