Outcomes after Surgical Resection of Hilar Cholangiocarcinoma
| Autor: | Seemab Khalid Ainy, Faisal Saud Dar, Abu Bakar Hafeez Bhatti, Neelam Shahzadi, Muhammad Atiq, Atif Rana |
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| Rok vydání: | 2018 |
| Předmět: |
Surgical resection
Adult Male Central Hepatectomy medicine.medical_specialty medicine.medical_treatment Portal vein Resection Cohort Studies Young Adult Blood loss Medicine Hepatectomy Humans Pakistan Aged business.industry General Medicine Length of Stay Middle Aged Surgery Survival Rate Treatment Outcome Bile Duct Neoplasms Female business Male to female Cohort study Klatskin Tumor |
| Zdroj: | Journal of the College of Physicians and Surgeons--Pakistan : JCPSP. 29(9) |
| ISSN: | 1681-7168 |
| Popis: | OBJECTIVE To report long term outcomes after surgical resection of hilar cholangiocarcinoma (hCCA). STUDY DESIGN Cohort study. PLACE AND DURATION OF STUDY Department of Liver Transplant and Hepatopancreaticobiliary Surgery, Shifa International Hospital, Islamabad, Pakistan, from October 2011 to April 2018. METHODOLOGY A prospective review of maintained database of patients who underwent surgical resection for hCCA was performed. A total of 24 patients were included. Outcome was assessed, based upon 90-day morbidity and mortality, 5-year recurrence-free survival (RFS) and overall survival (OS). RESULTS Median age was 49 (23-73) years. Male to female ratio was 1.4:1. Median CA 19-9 level was 113 (2-1200) U/ml. Nine patients (37.5%) underwent right hepatectomy, six had right trisectionectomy (25%), three had central hepatectomy (12.5%) and left hepatectomy (12.5%) each, while three (12.5%) had other surgical procedures. In addition, two (8.3%) patients required portal vein resection and reconstruction. Median blood loss was 1350 (100-2000) ml. Median ICU stay was 4 (2-13) days, while hospital stay was 10 (6-32) days. Sixteen (66.7%) patients experienced at least one morbidity within 90 days, while 90-day mortality was 1/24 (4.1%). The overall recurrence rate was 6/18 (33.4%) and mortality was 9/18 (50%). The actuarial 5-year RFS was 60% and OS was 39%. CONCLUSION hCCA remains a technically challenging surgical problem. Outcomes comparable to international standards can be achieved in experienced centres. |
| Databáze: | OpenAIRE |
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