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Comparative Study
. 2013 Apr;37(4):829-37.
doi: 10.1007/s00268-013-1909-9.

Liver resection for Bismuth type I and Type II hilar cholangiocarcinoma

Jin Hong Lim  1 , Gi Hong Choi, Sung Hoon Choi, Kyung Sik Kim, Jin Sub Choi, Woo Jung Lee
Affiliations
Comparative Study

Liver resection for Bismuth type I and Type II hilar cholangiocarcinoma

Jin Hong Lim et al. World J Surg. 2013 Apr.

Abstract

Background: In patients with Bismuth type I and II hilar cholangiocarcinoma (HCCA), bile duct resection alone has been the conventional approach. However, many authors have reported that concomitant liver resection improved surgical outcomes.

Methods: Between January 2000 and January 2012, 52 patients underwent surgical resection for a Bismuth type I and II HCCA (type I: n = 22; type II: n = 30). Patients were classified into two groups: concomitant liver resection (n = 26) and bile duct resection alone (n = 26).

Results: Bile duct resection alone was performed in 26 patients. Concomitant liver resection was performed in 26 patients (right side hepatectomy [n = 13]; left-side hepatectomy [n = 6]; volume-preserving liver resection [n = 7]). All liver resections included a caudate lobectomy. Patient and tumor characteristics did not differ between the two groups. Although concomitant liver resection required longer operating time (P < 0.001), it had a similar postoperative complication rate (P = 0.764), high curability (P = 0.010), and low local recurrence rate (P = 0.006). Concomitant liver resection showed better overall survival (P = 0.047).

Conclusions: Concomitant liver resection should be considered in patients with Bismuth type I and II HCCA.

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