Contemporary management of perihilar cholangiocarcinoma in a nontransplant hepatopancreatobiliary center.

Autor:	Jegatheeswaran S; Department of Surgery, Regional Hepatopancreatobiliary Surgery Unit, Manchester Royal Infirmary, Manchester, UK., Sheen AJ, Siriwardena AK
Jazyk:	angličtina
Zdroj:	European journal of gastroenterology & hepatology [Eur J Gastroenterol Hepatol] 2013 Sep; Vol. 25 (9), pp. 1099-104.
DOI:	10.1097/MEG.0b013e32835fba3a
Abstrakt:	Background: Perihilar cholangiocarcinoma (PHCC) is a rare tumor with a poor prognosis. Outcomes may be optimized by centralization. Recent trends suggest further improvement by localization to transplant centers. This study examines outcomes from the management of PHCC in a nontransplant hepatopancreatobiliary center. Methods: Data were collected prospectively from patients undergoing treatment for PHCC from October 1999 to May 2011. Twenty-four patients underwent surgery. A further 54 patients had inoperable PHCC. Outcome data are reported. Results: Twenty-two of 24 patients required liver resection with histological R0 status in 12 (50%). In-hospital mortality occurred in two (8%). The mean survival of patients undergoing resection was 39 (95% CI: 16-61) months. The mean survival of nonresected patients was 5 (95% CI: 3-7) months (P<0.0001; log-rank; Mantel-Cox test). Conclusion: Currently acceptable standards of holistic care for patients with PHCC can be provided in a nontransplant regional hepatopancreatobiliary center. Further centralization may improve resection volumes and allow more patients to benefit from extended liver resection techniques.
Databáze:	MEDLINE
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