The impact of portal vein resection on outcome of hilar cholangiocarcinoma

Ki Beom Kim; Dong Wook Choi; Jin Seok Heo; In Woong Han; Sang Hyun Shin; Yunghun You; Dae Joon Park

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자료유형: 학술저널

저자정보: Ki Beom Kim (Sungkyunkwan University School of Medicine) Dong Wook Choi (Sungkyunkwan University School of Medicine) Jin Seok Heo (Sungkyunkwan University School of Medicine) In Woong Han (Sungkyunkwan University School of Medicine) Sang Hyun Shin (Sungkyunkwan University School of Medicine) Yunghun You (Sungkyunkwan University School of Medicine) Dae Joon Park (Ewha Womans University School of Medicine)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제25권 제2호

발행연도: 2021.5

수록면: 221 - 229 (9page)

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Backgrounds/Aims: Portal vein resection (PVR) with major hepatic resection can increase the rate of curative resection for hilar cholangiocarcinoma (HC). However, the oncologic role and safety of PVR is still debatable. This study aims to analyze PVR in terms of safety and therapeutic effectiveness. Methods: We retrospectively analyzed 235 patients who had undergone major hepatic resection for HC with curative intent, including patients with PVR (PVR, n=35) consisting of PV invasion (PVR-A, n=9), No PV invasion (PVR-B, n=26); and patients without PVR (No PVR, n=200). Results: There was no significant difference in the 30-day mortality or postoperative morbidity between PVR and No PVR (2.9% vs. 1.0%; p=0.394 and 34.3% vs. 35.0%; p=0.875). The rate of advanced HC (T3: 40% vs. 12%; p＜0.001 and nodal metastasis: 60% vs. 28%; p＜0.001) was higher in PVR compared to No PVR. There was no significant difference in the 5-year overall survival rates and disease-free survival between PVR-A vs. PVR-B vs. No PVR. In multivariate analysis, estimated blood loss ＞600 ml (p=0.010), T3 diseases (p=0.001), nodal metastasis (p=0.001) and poor differentiation (p=0.002) were identified as independent risk factors for survival. Conclusions: PVR does not increase postoperative mortality or morbidity. It showed a similar oncologic outcome, despite a more advanced disease state in patients with HC. Given these findings, PVR should be actively performed if necessary, after careful patient selection.

#Hilar cholanagiocarcinoma #Portal vein resection #Mortality #Morbidity #Oncologic outcome

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