Vascular Resection in Perihilar Cholangiocarcinoma
Among the cholangiocarcinomas, the most common type is perihilar (phCC), accounting for approximately 60% of cases, after which are the distal and then intrahepatic forms. There is no staging system that allows for a comparison of all series and extraction of conclusions that increase the long-term...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-10-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/13/21/5278 |
| _version_ | 1797410949962924032 |
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| author | Alejandro Serrablo Leyre Serrablo Ruslan Alikhanov Luis Tejedor |
| author_facet | Alejandro Serrablo Leyre Serrablo Ruslan Alikhanov Luis Tejedor |
| author_sort | Alejandro Serrablo |
| collection | DOAJ |
| description | Among the cholangiocarcinomas, the most common type is perihilar (phCC), accounting for approximately 60% of cases, after which are the distal and then intrahepatic forms. There is no staging system that allows for a comparison of all series and extraction of conclusions that increase the long-term survival rate of this dismal disease. The extension of the resection, which theoretically depends on the type of phCC, is not a closed subject. As surgery is the only known way to achieve a cure, many aggressive approaches have been adopted. Despite extended liver resections and even vascular resections, margins are positive in around one third of patients. In the past two decades, with advances in diagnostic and surgical techniques, surgical outcomes and survival rates have gradually improved, although variability is the rule, with morbidity and mortality rates ranging from 14% to 76% and from 0% to 19%, respectively. Extended hepatectomies and portal vein resection, or even right hepatic artery reconstruction for the left side tumors are frequently needed. Salvage procedures when arterial reconstruction is not feasible, as well as hepatopancreatoduodenectomy, are still under evaluation too. In this article, we discuss the aggressive surgical approach to phCC focused on vascular resection. Disparate results on the surgical treatment of phCC made it impossible to reach clear-cut conclusions. |
| first_indexed | 2024-03-09T04:37:56Z |
| format | Article |
| id | doaj.art-4180456464c2451baaf7744a5ab8a493 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-09T04:37:56Z |
| publishDate | 2021-10-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-4180456464c2451baaf7744a5ab8a4932023-12-03T13:25:01ZengMDPI AGCancers2072-66942021-10-011321527810.3390/cancers13215278Vascular Resection in Perihilar CholangiocarcinomaAlejandro Serrablo0Leyre Serrablo1Ruslan Alikhanov2Luis Tejedor3Section of Surgery, European Union of Medical Specialists, 1040 Brussels, BelgiumMedicine School, Zaragoza University, 50009 Zaragoza, SpainDivision of Liver and Pancreatic Surgery, Moscow Clinical Research Center, 111123 Moscow, RussiaDepartment of Surgery, Punta Europa Hospital, 11207 Algeciras, SpainAmong the cholangiocarcinomas, the most common type is perihilar (phCC), accounting for approximately 60% of cases, after which are the distal and then intrahepatic forms. There is no staging system that allows for a comparison of all series and extraction of conclusions that increase the long-term survival rate of this dismal disease. The extension of the resection, which theoretically depends on the type of phCC, is not a closed subject. As surgery is the only known way to achieve a cure, many aggressive approaches have been adopted. Despite extended liver resections and even vascular resections, margins are positive in around one third of patients. In the past two decades, with advances in diagnostic and surgical techniques, surgical outcomes and survival rates have gradually improved, although variability is the rule, with morbidity and mortality rates ranging from 14% to 76% and from 0% to 19%, respectively. Extended hepatectomies and portal vein resection, or even right hepatic artery reconstruction for the left side tumors are frequently needed. Salvage procedures when arterial reconstruction is not feasible, as well as hepatopancreatoduodenectomy, are still under evaluation too. In this article, we discuss the aggressive surgical approach to phCC focused on vascular resection. Disparate results on the surgical treatment of phCC made it impossible to reach clear-cut conclusions.https://www.mdpi.com/2072-6694/13/21/5278perihilar cholangiocarcinomavascular invasion in perihilar cholangiocarcinomabiliary carcinomasurgery in vascular involvement |
| spellingShingle | Alejandro Serrablo Leyre Serrablo Ruslan Alikhanov Luis Tejedor Vascular Resection in Perihilar Cholangiocarcinoma Cancers perihilar cholangiocarcinoma vascular invasion in perihilar cholangiocarcinoma biliary carcinoma surgery in vascular involvement |
| title | Vascular Resection in Perihilar Cholangiocarcinoma |
| title_full | Vascular Resection in Perihilar Cholangiocarcinoma |
| title_fullStr | Vascular Resection in Perihilar Cholangiocarcinoma |
| title_full_unstemmed | Vascular Resection in Perihilar Cholangiocarcinoma |
| title_short | Vascular Resection in Perihilar Cholangiocarcinoma |
| title_sort | vascular resection in perihilar cholangiocarcinoma |
| topic | perihilar cholangiocarcinoma vascular invasion in perihilar cholangiocarcinoma biliary carcinoma surgery in vascular involvement |
| url | https://www.mdpi.com/2072-6694/13/21/5278 |
| work_keys_str_mv | AT alejandroserrablo vascularresectioninperihilarcholangiocarcinoma AT leyreserrablo vascularresectioninperihilarcholangiocarcinoma AT ruslanalikhanov vascularresectioninperihilarcholangiocarcinoma AT luistejedor vascularresectioninperihilarcholangiocarcinoma |