Current Surgical Management of Hilar and Intrahepatic Cholangiocarcinoma: The Role of Resection and Orthotopic Liver Transplantation

Abstract Cholangiocarcinoma (CCA) is a rare but devastating malignancy that presents late, is notoriously difficult to diagnose, and is associated with a high mortality. Surgical resection is the only chance for cure or long-term survival. The treatment of CCA has remained challenging because of the...

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Bibliographic Details
Published in:Transplantation proceedings 2009-12, Vol.41 (10), p.4023-4035
Main Authors: Petrowsky, H, Hong, J.C
Format: Article
Language:English
Subjects:
Bile Duct Neoplasms - epidemiology
Bile Duct Neoplasms - mortality
Bile Duct Neoplasms - pathology
Bile Duct Neoplasms - surgery
Bile Ducts, Intrahepatic - pathology
Bile Ducts, Intrahepatic - surgery
Cholangiocarcinoma - epidemiology
Cholangiocarcinoma - mortality
Cholangiocarcinoma - pathology
Cholangiocarcinoma - surgery
Embolization, Therapeutic
Humans
Incidence
Liver Transplantation - methods
Liver Transplantation - pathology
Portal Vein - pathology
Portal Vein - surgery
Surgery
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Summary:Abstract Cholangiocarcinoma (CCA) is a rare but devastating malignancy that presents late, is notoriously difficult to diagnose, and is associated with a high mortality. Surgical resection is the only chance for cure or long-term survival. The treatment of CCA has remained challenging because of the lack of effective adjuvant therapy, aggressive nature of the disease, and critical location of the tumor in close proximity to vital structures such as the hepatic artery and the portal vein. Moreover, the operative approach is dictated by the location of the tumor and the presence of underlying liver disease. During the past 4 decades, the operative management of CCA has evolved from a treatment modality that primarily aimed at palliation to curative intent with an aggressive surgical approach to R0 resection and total hepatectomy followed by orthotopic liver transplantation.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2009.11.001