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Revival of associat...
Revival of associating liver partition and portal vein ligation for staged hepatectomy for perihilar cholangiocarcinoma: An international multicenter study with promising outcomes
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- Balci, Deniz (författare)
- Bahcesehir Univ, Turkey
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- Nadalin, Silvio (författare)
- Univ Hosp Tubingen, Germany
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- Mehrabi, Arianeb (författare)
- Heidelberg Univ, Germany
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- Alikhanov, Ruslan (författare)
- Moscow Clin Res Ctr Named Loginov AS, Russia
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- Fernandes, Eduardo S. M. (författare)
- Univ Federaldo Rio de Janeiro, Brazil
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- Di Benedetto, Fabrizio (författare)
- Univ Modena & Reggio Emilia, Italy
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- Hernandez-Alejandro, Roberto (författare)
- Univ Rochester, NY USA
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- Björnsson, Bergthor (författare)
- Linköpings universitet,Avdelningen för kirurgi, ortopedi och onkologi,Medicinska fakulteten,Region Östergötland, Kirurgiska kliniken US
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- Efanov, Mikhail (författare)
- Moscow Clin Res Ctr Named Loginov AS, Russia
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- Capobianco, Ivan (författare)
- Univ Hosp Tubingen, Germany
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- Clavien, Pierre-Alain (författare)
- Univ Hosp Zurich, Switzerland
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- Kirimker, Elvan Onur (författare)
- Univ Sch Med Ankara, Turkey
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- Petrowsky, Henrik (författare)
- Univ Hosp Zurich, Switzerland
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(creator_code:org_t)
- MOSBY-ELSEVIER, 2023
- 2023
- Engelska.
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Ingår i: Surgery. - : MOSBY-ELSEVIER. - 0039-6060 .- 1532-7361. ; 173:6, s. 1398-1404
- Relaterad länk:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background: Associating liver partition and portal vein ligation for staged hepatectomy for per-ihilar cholangiocarcinoma has been considered to be contraindicated due to the initial poor results. Given the recent reports of improved outcomes, we aimed to collect the recent expe-riences of different centers performing associating liver partition and portal vein ligation for staged hepatectomy for perihilar cholangiocarcinoma to analyze factors related to improved outcomes. Methods: This proof-of-concept study collected contemporary cases of associating liver partition and portal vein ligation for staged hepatectomy for perihilar cholangiocarcinoma and analyzed for morbidity, short and long-term survival, and factors associated with outcomes. Results: In total, 39 patients from 8 centers underwent associating liver partition and portal vein ligation for staged hepatectomy for perihilar cholangiocarcinoma from 2010 to 2020. The median preoperative future liver remnant volume was 323 mL (155-460 mL). The median future liver remnant increase was 58.7% (8.9%-264. 5%) with a median interstage interval of 13 days (6-60 days). Post-stage 1 and post-stage 2 biliary leaks occurred in 2 (7.7%) and 4 (15%) patients. Six patients (23%) after stage 1 and 6 (23%) after stage 2 experienced grade 3 or higher complica-tions. Two patients (7.7%) died within 90 days after stage 2. The 1-, 3-, and 5-year survival was 92%, 69%, and 55%, respectively. A subgroup analysis revealed poor survival for patients under-going additional vascular resection and lymph node positivity. Lymph node-negative patients showed excellent survival demonstrated by 1-, 3-, and 5-year survival of 86%, 86%, and 86%. Conclusion: This study highlights that the critical attitude toward associating liver partition and portal vein ligation for staged hepatectomy for perihilar cholangiocarcinoma needs to be revised. In selected patients with perihilar cholangiocarcinoma, associating liver partition and portal vein ligation for staged hepatectomy can achieve favorable survival that compares to the outcome of established surgical treatment strategies reported in benchmark studies for perihilar cholangiocarcinoma including 1-stage hepatectomy and liver transplantation. (c) 2023 Elsevier Inc. All rights reserved.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kirurgi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Surgery (hsv//eng)
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Surgery
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- Av författaren/redakt...
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Balci, Deniz
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Nadalin, Silvio
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Mehrabi, Arianeb
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Alikhanov, Rusla ...
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Fernandes, Eduar ...
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Di Benedetto, Fa ...
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Hernandez-Alejan ...
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Björnsson, Bergt ...
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Efanov, Mikhail
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Capobianco, Ivan
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Clavien, Pierre- ...
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Kirimker, Elvan ...
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Petrowsky, Henri ...
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- MEDICIN OCH HÄLSOVETENSKAP
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MEDICIN OCH HÄLS ...
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och Klinisk medicin
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och Kirurgi
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Surgery
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Linköpings universitet