[Intrahepatic cholangiocarcinoma followed by vascular invasion: is surgical treatment justified?]

Autor: Akhaladze DG; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Alikhanov RB; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Efanov MG; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Kim PP; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Kazakov IV; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Vankovich AN; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Melekhina OV; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Kulezneva YV; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia., Tsvirkun VV; Hepatopancreatobiliary Surgery Department of the Loginov Moscow Clinical Scientific and Practical Center of Moscow Healthcare Department, Moscow, Russia.
Jazyk: ruština
Zdroj: Khirurgiia [Khirurgiia (Mosk)] 2018 (6), pp. 49-57.
DOI: 10.17116/hirurgia2018649-57
Abstrakt: Intrahepatic cholangiocarcinoma (ICC) is one of the most aggressive tumors associated with poor prognosis. Radical surgery is still the main method of treatment in resectable cases. Certain difficulties are observed in case of locally advanced tumors followed by inferior vena cava (IVC) and portal vein (PV) invasion.
Aim: To analyze safety of advanced liver resections combined with great vessels repair for locally advanced large and multiple cholangiocellular carcinoma.
Material and Methods: Since January 2014 till April 2017 eighty ICC patients have undergone advanced liver resection. There were 62 patients with portal cholangiocarcinoma and 18 with ICC. 4 ICC patients required vascular repair: IVC replacement in 2 cases (i.e. under venous bypass in 1 of them), tangential and circular resection of portal vein bifurcation - in 2 cases.
Results: Postoperative complications Clavien-Dindo IIIa developed in all cases. There were no vascular complications. The length of hospital-stay was 14 - 35 days. There were no lethal outcomes. Annual survival was 50%, 2-year - 25%. Adjuvant chemotherapy was used in all patients.
Conclusion: Advanced liver resection followed by IVC and PV repair for locally advanced ICC may be safely performed and subsequently allows chemotherapeutic treatment.
Databáze: MEDLINE