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Cholangiocarcinoma And Surgery

Francesca Ratti, Federica Cipriani, Guido Fiorentini, Camila Hidalgo Salinas, Marco Catena, Michele Paganelli, Luca Aldrighetti
BACKGROUND: The primary endpoint of this study was to evaluate the outcome of surgery for perihilar cholangiocarcinoma in a high-volume tertiary referral center. METHODS: The study population consisted of 196 consecutive patients with histologically confirmed perihilar cholangiocarcinoma-PHC-who were candidates to surgical treatment. Factors affecting postoperative morbidity were evaluated in the whole series (primary endpoint) and after stratification of patients according to the following criteria: (a) perioperative management protocol implementation; (b) monocentric management (secondary endpoint)...
July 17, 2018: Digestive and Liver Disease
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
Sung Hyun Kim, Dai Hoon Han, Gi Hong Choi, Jin Sub Choi, Kyung Sik Kim
BACKGROUND: Intrahepatic cholangiocarcinoma is a malignancy of the intrahepatic biliary tree. Although surgical resection is the mainstay of treatment for this tumor, the impact of lymph node dissection during hepatectomy is controversial. In this study, we evaluated the impact of lymph node dissection during surgical resection for intrahepatic cholangiocarcinoma. METHODS: Records from 170 patients who underwent radical hepatectomy for intrahepatic cholangiocarcinoma from January 2000 to December 2014 were retrospectively reviewed...
August 15, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Damien Bergeat, Olivier Turrini, Laetitia Courtin-Tanguy, Stéphanie Truant, Benjamin Darnis, Jean Robert Delpero, Jean-Yves Mabrut, Nicolas Regenet, Laurent Sulpice
BACKGROUND: The benefit of adjuvant chemotherapy (AC) after pancreaticoduodenectomy (PD) for distal cholangiocarcinoma (DCC) remains controversial. The study aimed to evaluate the impact of AC after PD for DCC in a large multicentric cohort. METHODS: Patients from five French centers who underwent from PD for DCC between 2000 and 2015 and received AC (AC+ group) or surgery only (AC- group) were included in the analysis. Variables associated with AC administration were analyzed by univariate analysis...
August 15, 2018: Langenbeck's Archives of Surgery
Wei Qin, Pengcheng Kang, Yi Xu, Kaiming Leng, Zhenglong Li, Lining Huang, Jianjun Gao, Yunfu Cui, Xiangyu Zhong
Cholangiocarcinoma (CCA) arising from the neoplastic transformation of cholangiocytes with increasing incidence in the worldwide. Unfortunately, a large amount of CCA patients lost their chance for surgery because it is hard to diagnose in the early stages. Long non-coding RNAs (lncRNAs) is closely associated with development and progression of various malignant tumors. Hox transcript antisense intergenic (HOTAIR), a negative prognostic factor for patients with gastric, liver and pancreatic carcinoma. Its transcription levels and functional roles in CCA is still unknown...
August 15, 2018: Scientific Reports
Katrin Hoffmann, Ulf Hinz, Christos Stravodimos, Tanja Knoblich, Michael R Schön, Markus W Büchler, Arianeb Mehrabi
BACKGROUND: In recent years, the profile for patients undergoing complex liver resections has changed, with mortality rates remaining generally stable. With these factors in mind, the objective of this study was to evaluate the variables associated with surgical outcomes after hepatectomy and identify groups at high risk for postoperative mortality. METHODS: The records of 1,796 patients who underwent liver resection of more than one liver segment at the Department of General and Transplantation Surgery, University Hospital Heidelberg, Germany, were analyzed...
August 11, 2018: Surgery
Oliver Beetz, Michael Klein, Harald Schrem, Jill Gwiasda, Florian W R Vondran, Felix Oldhafer, Sebastian Cammann, Jürgen Klempnauer, Karl J Oldhafer, Moritz Kleine
BACKGROUND: Distal cholangiocarcinoma (DCC) is a rare but over the last decade increasing malignancy and is associated with poor prognosis. According to the present knowledge curative surgery is the only chance for long term survival. This study was performed to evaluate prognostic factors for the outcome of patients undergoing curative surgery for distal cholangiocarcinoma. METHODS: 75 patients who underwent surgery between January 2000 and December 2014 for DCC in curative intention were analysed retrospectively...
August 13, 2018: BMC Surgery
Gu-Wei Ji, Yao-Dong Zhang, Ke Wang, Hui Zhang, Zi-Cheng Shao, Wang-Jie Jiang, Xiang-Cheng Li, Xue-Hao Wang
BACKGROUND: This study aimed to compare clinical outcomes of the middle hepatic vein (MHV)-oriented versus conventional hemihepatectomy for perihilar cholangiocarcinoma (PHC). METHODS: From 2008 to 2017, medical records of patients undergoing hemihepatectomy with caudate lobectomy for advanced PHC were reviewed retrospectively. MHV-oriented hepatectomy was defined as full exposure of the MHV on the dissection plane. Predictors of morbidity and survival were identified...
August 11, 2018: Journal of Surgical Oncology
Yuichi Nakaseko, Takeaki Ishizawa, Akio Saiura
In hepatobiliary surgery, fluorescence imaging enables identification of subcapsular liver tumors through accumulation of indocyanine green after preoperative intravenous injection in cancerous tissues of hepatocellular carcinoma and in noncancerous hepatic parenchyma around intrahepatic cholangiocarcinoma and liver metastases. Indocyanine green-fluorescence imaging can also be used for visualizing extrahepatic bile duct anatomy and hepatic segmental boundaries, enhancing the accuracy of open and laparoscopic hepatectomy...
August 11, 2018: Journal of Surgical Oncology
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)
Edward Willems, Bart Smet, Franceska Dedeurwaerdere, Mathieu D'Hondt
Intrahepatic cholangiocarcinoma (iCCA) is the second most common primary liver malignancy with poor survival rates. Surgical resection is the only curative treatment option, yet only a small portion of cases are resectable. In unresectable situations, suggested therapy consists of a systemic chemotherapy regimen with cisplatinum and gemcitabine. Selective internal radiation therapy (SIRT) has been proposed as an alternative treatment option and may lead to downstaging of unresectable iCCA to surgery. We present a case of a female patient diagnosed with an unresectable iCCA treated with SIRT in order to obtain downstaging...
August 9, 2018: Acta Chirurgica Belgica
Simone Conci, Andrea Ruzzenente, Luca Viganò, Giorgio Ercolani, Andrea Fontana, Fabio Bagante, Francesca Bertuzzo, Andrea Dore, Antonio Daniele Pinna, Guido Torzilli, Calogero Iacono, Alfredo Guglielmi
OBJECTIVE: We aimed to compare the clinicopathological features and survival after surgery of patients with intrahepatic cholangiocarcinoma (ICC) according to the patterns of distribution of hepatic nodules. METHODS: A retrospective analysis of a multi-institutional series of 259 patients with resected ICC was carried out. Patients were further classified according to the pattern of distribution of hepatic nodules: single tumors (type I), single tumors with satellites in the same liver segment (type II), or multifocal tumors (type III)...
August 7, 2018: Annals of Surgical Oncology
Pim B Olthof, Mamoru Miyasaka, Bas Groot Koerkamp, Jimme K Wiggers, William R Jarnagin, Takehiro Noji, Satoshi Hirano, Thomas M van Gulik
BACKGROUND: Perihilar cholangiocarcinoma (PHC) often requires extensive surgery which is associated with substantial morbidity and mortality. This study aimed to compare an Eastern and Western PHC cohort in terms of patient characteristics, treatment strategies and outcomes including a propensity score matched analysis. METHODS: All consecutive patients who underwent combined biliary and liver resection for PHC between 2005 and 2016 at two Western and one Eastern center were included...
August 4, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Kumiko Akashi, Tomoki Ebata, Takashi Mizuno, Yukihiro Yokoyama, Tsuyoshi Igami, Junpei Yamaguchi, Shunsuke Onoe, Masato Nagino
BACKGROUND: Whether operative treatment provides benefits for elderly patients with perihilar cholangiocarcinoma is unknown. The aim of this study was to review resection of perihilar cholangiocarcinoma according to age and to clarify its value for octogenarians. METHODS: Between April 1977 and December 2015, we reviewed consecutive patients who underwent resection for perihilar cholangiocarcinoma with a special focus on patient age. RESULTS: During the study interval, 831 patients underwent resection for perihilar cholangiocarcinoma...
August 3, 2018: Surgery
Jang Han Jung, Se Woo Park, Eun Shin
The current standard treatment of intrahepatic cholangiocarcinoma is surgical resection. However, in case the patient does not agree with surgical resection or is not fit for surgery, there are few ways of alternative treatment. We present a case report of an 83-year-old male patient with abdominal pain who was diagnosed with polypoid intrahepatic cholangiocarcinoma in the left IHD with peripheral IHD dilatation. He refused to undergo curative surgery. Alternatively, he underwent endoscopic mucosal resection (EMR) with direct per-oral cholangioscopy (POC) using standard upper endoscopy with a transparent cap...
August 6, 2018: Digestive Endoscopy: Official Journal of the Japan Gastroenterological Endoscopy Society
Xi-Tai Huang, Chen-Song Huang, Jian-Hui Li, Jian-Peng Cai, Wei Chen, Xiao-Yu Yin
BACKGROUND: This study aimed to clarify the prognostic significance of neutrophil/prealbumin ratio index (NPRI) for overall survival (OS) and recurrence free survival (RFS) of ICC after curative surgery. METHODS: Two-hundred and seventy-six ICC patients who underwent curative resection from December 2006 to April 2017 were recruited and analyzed retrospectively. The correlations between clinicopathological features and NPRI were analyzed. OS and RFS were calculated using Kaplan-Meier curve, and cox univariate and multivariate analyses were used to identify the prognostic factors...
August 2, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Sungwon Kim, Chansik An, Kyunghwa Han, Myeong-Jin Kim
PURPOSE: To identify imaging markers that independently predict the post-operative outcome of intrahepatic mass-forming cholangiocarcinoma (IMCC) using gadoxetate disodium-enhanced magnetic resonance imaging (MRI). METHODS: Data from 54 patients who underwent pre-operative gadoxetate disodium-enhanced MRI and curative surgery for IMCC were retrospectively evaluated. The prognostic power of various imaging and pathological features reportedly associated with recurrence-free survival (RFS) and overall survival (OS) was analyzed using Cox regression models...
August 4, 2018: Abdominal Radiology
Aussara Panya, Chutamas Thepmalee, Nunghathai Sawasdee, Jatuporn Sujjitjoon, Nattaporn Phanthaphol, Mutita Junking, Sopit Wongkham, Pa-Thai Yenchitsomanus
Cholangiocarcinoma (CCA) is a cancer of the bile ducts that is associated with poor prognosis and poor treatment outcome. Approximately one-third of CCA patients can undergo surgery, but the recurrence rate is high and chemotherapy often cannot satisfactorily prolong survival. Cellular immunotherapy based on adoptive T-cell transfer is a potential treatment for CCA; however, the development of this technology and the search for an appropriate tumor-associated antigen are still ongoing. To enhance the cytotoxic activity of effector T cells against CCA, we developed self-differentiated monocyte-derived dendritic cells (SD-DC) presenting cAMP-dependent protein kinase type I-alpha regulatory subunit (PRKAR1A), which is an overexpressed protein that plays a role in the regulation of tumor growth to activate T cells for CCA cell killing...
July 28, 2018: Cancer Immunology, Immunotherapy: CII
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
Maciej Walędziak, Anna Różańska-Walędziak, Piotr K Kowalewski, Krzysztof Paśnik
Intrahepatic cholangiocarcinoma is a rare type of biliary tract malignancy, seldom found resectable at diagnosis, the 5-year survival rate depending on the possibility of complete surgical excision. In most cases it is only accidentally found in the early stage. The report presents a case of a 58-year-old obese male patient qualified for laparoscopic Roux-en-Y gastric bypass. During general inspection of the abdominal cavity, a tumor of 10 mm in diameter was found in the second hepatic segment and resected...
June 2018: Wideochirurgia i Inne Techniki Mało Inwazyjne, Videosurgery and Other Miniinvasive Techniques
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