Surgery, Gastroenterology and Oncology
Vol. 23, No. 4, Aug 2018
Operative Management and Outcomes of 150 Patients with Curative-intent Surgery for Perihilar Cholangiocarcinomas: A Single Institute East European Perspective
Traian Dumitrascu, Vladislav Brasoveanu, Cezar Stroescu, Mihnea Ionescu, Irinel Popescu
ORIGINAL PAPER, Aug 2018
Article DOI: 10.21614/sgo-23-4-267
Introduction: The knowledge of current approach and outcomes of curative-intent surgery for perihilar cholangiocarcinoma (PHC) has been highlighted in studies of the literature including mainly East Asian and Western patients.
Thus, papers presenting the curative-intent surgery in East Europe are scarce. The study aims to present the operative management and outcomes of curative-intent surgery for PHC in an East European institutional experience.

Patients and methods: The data of all patients with curative-intent surgery for PHC between 1996 and 2017 were retrospectively reviewed from a prospective maintained electronic database at our Department of Surgery. The assessment was made for the operative management and early and late outcomes.

Results: Liver resections were performed in 80.7% of patients, with caudate lobectomies in 64.7% of cases. Vascular resections were performed in 19.4% of patients. Preoperative biliary drainage was performed in 26% of patients. Negative resection margins were obtained in 76.7% of patients. Overall and severe morbidity rates were 57.3% and 24%, respectively.
Postoperative bile leak, liver failure and hemorrhage rates were 31.3%, 24.7% and 10%, respectively. The 90-day mortality rate was 6%. The median overall and disease-free survival times were 26 months and 21 months, respectively. Conclusion: The standard approach for curative-intent surgery for PHC implies bile duct resection associated with major hepatectomies, including caudate lobectomy.
Expertise in referral surgical centers of East Europe is associated with morbidity, mortality and overall survival rates comparable with those reported in Western centres, despite low rate of preoperative biliary drainage and no use of portal vein embolization.
Improvements of preoperative optimization with portal vein embolization and biliary drainage may potentially lead to better early and long-term outcomes.

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ISSN: 2559 - 723X (print)

e-ISSN: 2601 - 1700 (online)

ISSN-L: 2559 - 723X

Journal Abbreviation: Surg. Gastroenterol. Oncol.

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