Surgery, Gastroenterology and Oncology

Read article Perihilar cholangiocarcinoma (PCC) is a devastating disease with poor prognosis. Surgical resection remains a first-line therapy in patients with PCC, and the primary goal is to gain a tumor-free surgical margin.

However, surgical margins are sometimes involved after curative intent surgery even now, which is plausibly explained by the fact that there is a potential gap between the extent of radiologic tumor staging and that of histologic cancer invasion.
It is known that cancer cells of cholangiocarcinoma invade the surrounding area beyond the gross tumor border. The....[more]

Read article The indications for liver transplantation in hepatobiliary malignancies have been carefully expanded, giving rise to a new era of Transplant Oncology, the fusion of transplantation medicine and oncology.
Curative resection is the only curative therapy for perihilar cholangiocarcinoma. Liver transplantation may achieve a complete resection with adequate negative margins in patients with locally advanced, unresectable disease due to bilateral invasion of second-order biliary radicals, portal vein and or hepatic artery involvement, or insufficient hepatic reserve.
An aggress....[more]

Read article Cholangiocarcinoma is a fatal cancer arising from the biliary endothelium. Perihilar cholangiocarcinoma (pCCA) is the most common variant of cholangiocarcinoma, with increasing incidence worldwide.
Most pCCA patients present with unresectable disease at the time of diagnosis, and many patients are found to be unresectable after surgical exploration. pCCA carries a poor prognosis as more than 65% of the patients are presented with non-resectable disease at the time of diagnosis, and about 10% to 45% of patients are found to be unresectable after surgical exploration.
Surgi....[more]

Read article Surgical resection with negative margins is the standard treatment for perihilar cholangiocarcinoma whenever possible. Patient's frequent low performance status at presentation and need of extended resections require optimization of the patient's condition in the preoperative setting. Biliary drainage is mandatory in case of cholangitis, jaundice-related liver insufficiency, malnutrition or renal failure.

Drainage is also necessary in case of portal vein embolization (PVE), in order to improve regeneration of the future liver remnant (FLR). Unilateral drainage of the FLR sh....[more]