Application of extended radical surgery in hilar cholangiocarcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

HU Yafei , HU Haijie ,  LI Fuyu

Department of Biliary Surgery, West China Hospital of Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

LI Fuyu, Email: lfy_74@hotmail.com

Keywords：

hilar cholangiocarcinoma; extended radical surgery; survival prognosis

DOI：

10.7507/1007-9424.202207010

Video：

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Abstract Full text Figures/Tables Video References Cited by

At present, the application of extended radical surgery in hilar cholangiocarcinoma (hCCA) remained controversial. The author reviewed the relevant literatures published in recent years and combined with his own experience, preliminarily discussed the application value of extended radical surgery in hCCA, and believed that: for some strictly selected cases of hCCA, under the premise of ensuring patient safety, extended radical surgery was an important treatment method for hCCA patients to obtain R0 removal, and the survival status of patients was better than that of palliative surgery, but the indications need to be strictly mastered. For patients with hCCA, whether to adopt extended radical surgery and the specific scope of surgical resection should be based on the scope of lesions and the involved organs, tissues and blood vessels to implement an individualized surgical program on the premise of comprehensive evaluation and full preparation before surgery. Do not blindly carry out extended radical surgery.

Citation： HU Yafei, HU Haijie, LI Fuyu. Application of extended radical surgery in hilar cholangiocarcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(12): 1554-1558. doi: 10.7507/1007-9424.202207010 Copy

1.	Soares KC, Jarnagin WR. The landmark series: hilar cholangiocarcinoma. Ann Surg Oncol, 2021, 28(8): 4158-4170.
2.	Lauterio A, De Carlis R, Centonze L, et al. Current surgical management of peri-hilar and intra-hepatic cholangiocarcinoma. Cancers (Basel), 2021, 13(15): 3657.
3.	Izquierdo-Sanchez L, Lamarca A, La Casta A, et al. Cholangio-carcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry. J Hepatol, 2022, 76(5): 1109-1121.
4.	Littau MJ, Kim P, Kulshrestha S, et al. Resectable intrahepatic and hilar cholangiocarcinoma: Is margin status associated with survival? Surgery, 2022, 171(3): 703-710.
5.	Istanbouli A, Patel S, Almerey T, et al. Surgical treatment for intrahepatic, peri-hilar, and distal cholangiocarcinoma: 20-single institutional year experience. Am Surg, 2021: 31348211034751.
6.	She WH, Cheung TT, Ma KW, et al. Vascular resection and reconstruction in hilar cholangiocarcinoma. ANZ J Surg, 2020, 90(9): 1653-1659.
7.	Mueller M, Breuer E, Mizuno T, et al. Perihilar cholangio-carcinoma—Novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann Surg, 2021, 274(5): 780-788.
8.	Angelico R, Sensi B, Parente A, et al. Vascular involvements in cholangiocarcinoma: tips and tricks. Cancers (Basel), 2021, 13(15): 3735.
9.	Sapisochin G, Ivanics T, Subramanian V, et al. Multidisciplinary treatment for hilar and intrahepatic cholangiocarcinoma: A review of the general principles. Int J Surg, 2020, 82S: 77-81.
10.	van Keulen AM, Olthof PB, Cescon M, et al. Actual 10-year survival after resection of perihilar cholangiocarcinoma: what factors preclude a chance for cure? Cancers (Basel), 2021, 13(24): 6260. doi: 10.3390/cancers13246260.
11.	Nagino M, Ebata T, Yokoyama Y, et al. Hepatopancreato-duodenectomy with simultaneous resection of the portal vein and hepatic artery for locally advanced cholangiocarcinoma: Short- and long-term outcomes of superextended surgery. J Hepatobiliary Pancreat Sci, 2021, 28(4): 376-386.
12.	van Keulen AM, Franssen S, van der Geest LG, et al. Nationwide treatment and outcomes of perihilar cholangiocarcinoma. Liver Int, 2021, 41(8): 1945-1953.
13.	Daradkeh S. A case series of hilar cholangiocarcinoma: A single surgeon experience over 20-years. Ann Med Surg (Lond), 2021, 62: 239-243.
14.	van Keulen AM, Buettner S, Besselink MG, et al. Primary and secondary liver failure after major liver resection for perihilar cholangiocarcinoma. Surgery, 2021, 170(4): 1024-1030.
15.	Balci D, McCormack L. Perihilar cholangiocarcinoma: A difficult surgery in a difficult patient where experience matters most. Surgery, 2021, 170(2): 644-645.
16.	Li CG, Zhou ZP, Tan XL, et al. Perineural invasion of hilar cholangiocarcinoma in Chinese population: One center’s experience. World J Gastrointest Oncol, 2020, 12(4): 457-466.
17.	Utsumi M, Sadamori H, Shinoura S et al. Risk factors of morbidity and predictors of long-term survival after hepatopancreato-duodenectomy for biliary cancer. Hepatogastroenterology, 2014, 61(136): 2167-2172.
18.	Liu F, Hu HJ, Ma WJ, et al. Is radical resection of hilar cholangiocarcinoma plus partial resection of pancreatic head justified for advanced hilar cholangiocarcinoma? ANZ J Surg, 2020, 90(9): 1666-1670.
19.	Sumiyoshi T, Uemura K, Kondo N, et al. Is surgery justified for elderly patients with extrahepatic cholangiocarcinoma? Reappraisal from a viewpoint of comorbidity and organ function. Surg Today, 2021, 51(11): 1787-1794.
20.	Yohanathan L, Croome KP, Traynor M, et al. Significance of proximal ductal margin status after resection of hilar cholangiocarcinoma. HPB (Oxford), 2021, 23(1): 109-117.
21.	Ebata T, Yokoyama Y, Igami T, et al. Hepatopancreato-duodenectomy for cholangiocarcinoma: a single-center review of 85 consecutive patients. Ann Surg, 2012, 256(2): 297-305.
22.	Aoki T, Sakamoto Y, Kohno Y, et al. Hepatopancreatico-duodenectomy for biliary cancer: strategies for near-zero operative mortality and acceptable long-term outcome. Ann Surg, 2018, 267(2): 332-337.
23.	D’Souza MA, Valdimarsson VT, Campagnaro T, et al. Hepatopancreatoduodenectomy—a controversial treatment for bile duct and gallbladder cancer from a European perspective. HPB (Oxford), 2020, 22(9): 1339-1348.
24.	Ishii T, Seo S, Ito T, et al. Liver Transection-first approach in hepatopancreatoduodenectomy for hilar cholangiocarcinoma: A safe and secure technique for the early assessment of curable resection and vascular reconstruction. Ann Surg Oncol, 2021, 28(6): 2988-2989.
25.	Mizuno T, Ebata T, Nagino M. Advanced hilar cholangio-carcinoma: An aggressive surgical approach for the treatment of advanced hilar cholangiocarcinoma: Perioperative management, extended procedures, and multidisciplinary approaches. Surg Oncol, 2020, 33: 201-206.
26.	Ruzzenente A, Bagante F, Olthof PB, et al. Surgery for bismuth-corlette type 4 perihilar cholangiocarcinoma: results from a western multicenter collaborative group. Ann Surg Oncol, 2021, 28(12): 7719-7729.
27.	Mehrotra S, Lalwani S, Nundy S. Management strategies for patients with hilar cholangiocarcinomas: challenges and solutions. Hepat Med, 2020, 12: 1-13.
28.	Kim KB, Choi DW, Heo JS, et al. The impact of portal vein resection on outcome of hilar cholangiocarcinoma. Ann Hepatobiliary Pancreat Surg, 2021, 25(2): 221-229.
29.	Chen W, Ke K, Chen YL. Combined portal vein resection in the treatment of hilar cholangiocarcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2014, 40(5): 489-495.
30.	Song Y, Zhang Y, Zhen Z, et al. Effects of portal vein resection and hepatic artery resection on long-term survival in Klatskin tumor: a meta-analysis. World J Surg Oncol, 2022, 20(1): 230.
31.	Mizuno T, Ebata T, Yokoyama Y, et al. Combined vascular resection for locally advanced perihilar cholangiocarcinoma. Ann Surg, 2022, 275(2): 382-390.
32.	Sugiura T, Uesaka K, Okamura Y, et al. Major hepatectomy with combined vascular resection for perihilar cholangiocarcinoma. BJS Open, 2021, 5(4): zrab064.
33.	Abbas S, Sandroussi C. Systematic review and meta-analysis of the role of vascular resection in the treatment of hilar cholangiocarcinoma. HPB (Oxford), 2013, 15(7): 492-503.
34.	Rebelo A, Friedrichs J, Grilli M, et al. Systematic review and meta-analysis of surgery for hilar cholangiocarcinoma with arterial resection. HPB (Oxford), 2022, S1365-182X(22): 00097-1.
35.	陈海明, 付志豪, 邓东锋, 等. 联合肝动脉切除治疗肝门部胆管癌安全性及疗效的荟萃分析. 中华医学杂志, 2021, 101(4): 286-292.
36.	Soares KC, Jarnagin WR. ASO Author reflections: hilar cholangiocarcinoma. Ann Surg Oncol, 2021, 28(8): 4171-4172.

1. Soares KC, Jarnagin WR. The landmark series: hilar cholangiocarcinoma. Ann Surg Oncol, 2021, 28(8): 4158-4170.
2. Lauterio A, De Carlis R, Centonze L, et al. Current surgical management of peri-hilar and intra-hepatic cholangiocarcinoma. Cancers (Basel), 2021, 13(15): 3657.
3. Izquierdo-Sanchez L, Lamarca A, La Casta A, et al. Cholangio-carcinoma landscape in Europe: Diagnostic, prognostic and therapeutic insights from the ENSCCA Registry. J Hepatol, 2022, 76(5): 1109-1121.
4. Littau MJ, Kim P, Kulshrestha S, et al. Resectable intrahepatic and hilar cholangiocarcinoma: Is margin status associated with survival? Surgery, 2022, 171(3): 703-710.
5. Istanbouli A, Patel S, Almerey T, et al. Surgical treatment for intrahepatic, peri-hilar, and distal cholangiocarcinoma: 20-single institutional year experience. Am Surg, 2021: 31348211034751.
6. She WH, Cheung TT, Ma KW, et al. Vascular resection and reconstruction in hilar cholangiocarcinoma. ANZ J Surg, 2020, 90(9): 1653-1659.
7. Mueller M, Breuer E, Mizuno T, et al. Perihilar cholangio-carcinoma—Novel benchmark values for surgical and oncological outcomes from 24 expert centers. Ann Surg, 2021, 274(5): 780-788.
8. Angelico R, Sensi B, Parente A, et al. Vascular involvements in cholangiocarcinoma: tips and tricks. Cancers (Basel), 2021, 13(15): 3735.
9. Sapisochin G, Ivanics T, Subramanian V, et al. Multidisciplinary treatment for hilar and intrahepatic cholangiocarcinoma: A review of the general principles. Int J Surg, 2020, 82S: 77-81.
10. van Keulen AM, Olthof PB, Cescon M, et al. Actual 10-year survival after resection of perihilar cholangiocarcinoma: what factors preclude a chance for cure? Cancers (Basel), 2021, 13(24): 6260. doi: 10.3390/cancers13246260.
11. Nagino M, Ebata T, Yokoyama Y, et al. Hepatopancreato-duodenectomy with simultaneous resection of the portal vein and hepatic artery for locally advanced cholangiocarcinoma: Short- and long-term outcomes of superextended surgery. J Hepatobiliary Pancreat Sci, 2021, 28(4): 376-386.
12. van Keulen AM, Franssen S, van der Geest LG, et al. Nationwide treatment and outcomes of perihilar cholangiocarcinoma. Liver Int, 2021, 41(8): 1945-1953.
13. Daradkeh S. A case series of hilar cholangiocarcinoma: A single surgeon experience over 20-years. Ann Med Surg (Lond), 2021, 62: 239-243.
14. van Keulen AM, Buettner S, Besselink MG, et al. Primary and secondary liver failure after major liver resection for perihilar cholangiocarcinoma. Surgery, 2021, 170(4): 1024-1030.
15. Balci D, McCormack L. Perihilar cholangiocarcinoma: A difficult surgery in a difficult patient where experience matters most. Surgery, 2021, 170(2): 644-645.
16. Li CG, Zhou ZP, Tan XL, et al. Perineural invasion of hilar cholangiocarcinoma in Chinese population: One center’s experience. World J Gastrointest Oncol, 2020, 12(4): 457-466.
17. Utsumi M, Sadamori H, Shinoura S et al. Risk factors of morbidity and predictors of long-term survival after hepatopancreato-duodenectomy for biliary cancer. Hepatogastroenterology, 2014, 61(136): 2167-2172.
18. Liu F, Hu HJ, Ma WJ, et al. Is radical resection of hilar cholangiocarcinoma plus partial resection of pancreatic head justified for advanced hilar cholangiocarcinoma? ANZ J Surg, 2020, 90(9): 1666-1670.
19. Sumiyoshi T, Uemura K, Kondo N, et al. Is surgery justified for elderly patients with extrahepatic cholangiocarcinoma? Reappraisal from a viewpoint of comorbidity and organ function. Surg Today, 2021, 51(11): 1787-1794.
20. Yohanathan L, Croome KP, Traynor M, et al. Significance of proximal ductal margin status after resection of hilar cholangiocarcinoma. HPB (Oxford), 2021, 23(1): 109-117.
21. Ebata T, Yokoyama Y, Igami T, et al. Hepatopancreato-duodenectomy for cholangiocarcinoma: a single-center review of 85 consecutive patients. Ann Surg, 2012, 256(2): 297-305.
22. Aoki T, Sakamoto Y, Kohno Y, et al. Hepatopancreatico-duodenectomy for biliary cancer: strategies for near-zero operative mortality and acceptable long-term outcome. Ann Surg, 2018, 267(2): 332-337.
23. D’Souza MA, Valdimarsson VT, Campagnaro T, et al. Hepatopancreatoduodenectomy—a controversial treatment for bile duct and gallbladder cancer from a European perspective. HPB (Oxford), 2020, 22(9): 1339-1348.
24. Ishii T, Seo S, Ito T, et al. Liver Transection-first approach in hepatopancreatoduodenectomy for hilar cholangiocarcinoma: A safe and secure technique for the early assessment of curable resection and vascular reconstruction. Ann Surg Oncol, 2021, 28(6): 2988-2989.
25. Mizuno T, Ebata T, Nagino M. Advanced hilar cholangio-carcinoma: An aggressive surgical approach for the treatment of advanced hilar cholangiocarcinoma: Perioperative management, extended procedures, and multidisciplinary approaches. Surg Oncol, 2020, 33: 201-206.
26. Ruzzenente A, Bagante F, Olthof PB, et al. Surgery for bismuth-corlette type 4 perihilar cholangiocarcinoma: results from a western multicenter collaborative group. Ann Surg Oncol, 2021, 28(12): 7719-7729.
27. Mehrotra S, Lalwani S, Nundy S. Management strategies for patients with hilar cholangiocarcinomas: challenges and solutions. Hepat Med, 2020, 12: 1-13.
28. Kim KB, Choi DW, Heo JS, et al. The impact of portal vein resection on outcome of hilar cholangiocarcinoma. Ann Hepatobiliary Pancreat Surg, 2021, 25(2): 221-229.
29. Chen W, Ke K, Chen YL. Combined portal vein resection in the treatment of hilar cholangiocarcinoma: a systematic review and meta-analysis. Eur J Surg Oncol, 2014, 40(5): 489-495.
30. Song Y, Zhang Y, Zhen Z, et al. Effects of portal vein resection and hepatic artery resection on long-term survival in Klatskin tumor: a meta-analysis. World J Surg Oncol, 2022, 20(1): 230.
31. Mizuno T, Ebata T, Yokoyama Y, et al. Combined vascular resection for locally advanced perihilar cholangiocarcinoma. Ann Surg, 2022, 275(2): 382-390.
32. Sugiura T, Uesaka K, Okamura Y, et al. Major hepatectomy with combined vascular resection for perihilar cholangiocarcinoma. BJS Open, 2021, 5(4): zrab064.
33. Abbas S, Sandroussi C. Systematic review and meta-analysis of the role of vascular resection in the treatment of hilar cholangiocarcinoma. HPB (Oxford), 2013, 15(7): 492-503.
34. Rebelo A, Friedrichs J, Grilli M, et al. Systematic review and meta-analysis of surgery for hilar cholangiocarcinoma with arterial resection. HPB (Oxford), 2022, S1365-182X(22): 00097-1.
35. 陈海明, 付志豪, 邓东锋, 等. 联合肝动脉切除治疗肝门部胆管癌安全性及疗效的荟萃分析. 中华医学杂志, 2021, 101(4): 286-292.
36. Soares KC, Jarnagin WR. ASO Author reflections: hilar cholangiocarcinoma. Ann Surg Oncol, 2021, 28(8): 4171-4172.

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Application of extended radical surgery in hilar cholangiocarcinoma

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